Inhibitors of 11beta-hydroxysteroid dehydrogenase 1

ABSTRACT

This invention relates to novel compounds of the Formula (I), (Ia 1-10 ), (Ib 1-10 ), (Ic 1-10 ), (Id 1-7 ), (Ie 1-5 ) pharmaceutically acceptable salts thereof, and pharmaceutical compositions thereof, which are useful for the therapeutic treatment of diseases associated with the modulation or inhibition of 11β-HSD1 in mammals. The invention further relates to pharmaceutical compositions of the novel compounds and methods for their use in the reduction or control of the production of cortisol in a cell or the inhibition of the conversion of cortisone to cortisol in a cell.

FIELD OF THE INVENTION

The present invention relates to inhibitors of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), pharmaceutical compositions thereof and methods of using the same.

BACKGROUND OF THE INVENTION

Glucocorticoids, such as cortisol (hydrocortisone), are steroid hormones that regulate fat metabolism, function and distribution, and play a role in carbohydrate, protein and fat metabolism. Glucocorticoids are also known to have physiological effects on development, neurobiology, inflammation, blood pressure, metabolism, and programmed cell death. Cortisol and other corticosteroids bind both the glucocorticoid receptor (GR) and the mineralocorticoid receptor (MR), which are members of the nuclear hormone receptor superfamily and have been shown to mediate cortisol function in vivo. These receptors directly modulate transcription via DNA-binding zinc finger domains and transcriptional activation domains.

Until recently, the major determinants of glucocorticoid action were attributed to three primary factors: (1) circulating levels of glucocorticoid (driven primarily by the hypothalamic-pituitary-adrenal (HPA) axis); (2) protein binding of glucocorticoids in circulation; and (3) intracellular receptor density inside target tissues. Recently, a fourth determinant of glucocorticoid function has been identified: tissue-specific pre-receptor metabolism by glucocorticoid-activating and -inactivating enzymes. These 11β-hydroxysteroid dehydrogenase (11β-HSD) pre-receptor control enzymes modulate activation of GR and MR by regulation of glucocorticoid hormones. To date, two distinct isozymes of 11-beta-HSD have been cloned and characterized: 11β-HSD1 (also known as 11-beta-HSD type 1, 11betaHSD1, HSD11B1, HDL, and HSD11L) and 11β-HSD2. 11β-HSD1 is a bi-directional oxidoreductase that regenerates active cortisol from inactive 11-keto forms, whereas 11β-HSD2 is a unidirectional dehydrogenase that inactivates biologically active cortisol by converting it into cortisone.

The two isoforms are expressed in a distinct tissue-specific fashion, consistent with the differences in their physiological roles. 11β-HSD1 is widely distributed in rat and human tissues; expression of the enzyme and corresponding mRNA have been detected in human liver, adipose tissue, lung, testis, bone and ciliary epithelium. In adipose tissue, increased cortisol concentrations stimulate adipocyte differentiation and may play a role in promoting visceral obesity. In the eye, 11β-HSD1 may regulate intraocular pressure and may contribute to glaucoma; some data suggest that inhibition of 11β-HSD1 may cause a drop in intraocular pressure in patients with intraocular hypertension (Kotelevstev et al. (1997), Proc. Natl. Acad. Sci. USA 94(26):14924-9). Although 11β-HSD1 catalyzes both 11-beta-dehydrogenation and the reverse 11-oxoreduction reaction, 11β-HSD1 acts predominantly as a NADPH-dependent oxoreductase in intact cells and tissues, catalyzing the formation of active cortisol from inert cortisone (Low et al. (1994) J. Mol. Endocrin. 13: 167-174). In contradistinction, 11β-HSD2 expression is found mainly in mineralocorticoid target tissues such as kidney (cortex and medulla), placenta, sigmoid and rectal colon, salivary gland and colonic epithelial cell lines. 11β-HSD2 acts as an NAD-dependent dehydrogenase catalyzing the inactivation of cortisol to cortisone (Albiston et al. (1994) Mol. Cell. Endocrin. 105: R11-R17), and has been shown to protect the MR from glucocorticoid excess (e.g., high levels of receptor-active cortisol) (Blum, et al. (2003) Prog. Nucl. Acid Res. Mol. Biol. 75:173-216).

Mutations in either the 11β-HSD1 or the 11β-HSD2 genes result in human pathology. For example, individuals with mutations in 11β-HSD2 are deficient in this cortisol-inactivation activity and, as a result, present with a syndrome of apparent mineralocorticoid excess (also referred to as ‘SAME’) characterized by hypertension, hypokalemia, and sodium retention (Edwards et al. (1988) Lancet 2: 986-989; Wilson et al. (1998) Proc. Natl. Acad. Sci. 95: 10200-10205). Similarly, mutations in 11β-HSD1 and in the gene encoding a co-localized NADPH-generating enzyme, hexose 6-phosphate dehydrogenase (H6PD), can result in cortisone reductase deficiency (CRD); these individuals present with ACTH-mediated androgen excess (hirsutism, menstrual irregularity, hyperandrogenism), a phenotype resembling polycystic ovary syndrome (PCOS) (Draper et al. (2003) Nat. Genet. 34: 434-439).

Notably, disruption of homeostasis in the HPA axis by either deficient or excess secretion or action results in Cushing's syndrome or Addison's disease, respectively (Miller and Chrousos (2001) Endocrinology and Metabolism, eds. Felig and Frohman (McGraw-Hill, New York), 4^(th) Ed.: 387-524). Patients with Cushing's syndrome or receiving glucocorticoid therapy develop reversible visceral fat obesity. The phenotype of Cushing's syndrome patients closely resembles that of Reaven's metabolic syndrome (also known as Syndrome X or insulin resistance syndrome), the symptoms of which include visceral obesity, glucose intolerance, insulin resistance, hypertension, type 2 diabetes and hyperlipidemia (Reaven (1993) Ann Rev. Med. 44: 121-131). Although the role of glucocorticoids in human obesity is not fully characterized, there is mounting evidence that 11β-HSD1 activity plays an important role in obesity and metabolic syndrome (Bujalska et al. (1997) Lancet 349: 1210-1213); (Livingstone et al. (2000) Endocrinology 131: 560-563; Rask et al. (2001) J. Clin. Endocrinol. Metab. 86: 1418-1421; Lindsay et al. (2003) J. Clin. Endocrinol. Metab. 88: 2738-2744; Wake et al. (2003) J. Clin. Endocrinol. Metab. 88: 3983-3988).

Data from studies in mouse transgenic models supports the hypothesis that adipocyte 11β-HSD1 activity plays a central role in visceral obesity and metabolic syndrome (Alberts et al. (2002) Diabetologia. 45(11): 1526-32). Over-expression in adipose tissue of 11β-HSD1 under the control of the aP2 promoter in transgenic mice produced a phenotype remarkably similar to human metabolic syndrome (Masuzaki et al. (2001) Science 294: 2166-2170; Masuzaki et al. (2003) J. Clinical Invest. 112: 83-90). Moreover, the increased activity of 11β-HSD1 in these mice is very similar to that observed in human obesity (Rask et al. (2001) J. Clin. Endocrinol. Metab. 86: 1418-1421). In addition, data from studies with 11β-HSD1-deficient mice produced by homologous recombination demonstrate that the loss of 11β-HSD1 leads to an increase in insulin sensitivity and glucose tolerance due to a tissue-specific deficiency in active glucocorticoid levels (Kotelevstev et al. (1997) Proc. Natl. Acad. Sci. 94: 14924-14929; Morton et al. (2001) J. Biol. Chem. 276: 41293-41300; Morton et al. (2004) Diabetes 53: 931-938).

The published data supports the hypothesis that increased expression of 11≈-HSD1 contributes to increased local conversion of cortisone to cortisol in adipose tissue and hence that 11β-HSD1 plays a role in the pathogenesis of central obesity and the appearance of the metabolic syndrome in humans (Engeli, et al., (2004) Obes. Res. 12: 9-17). Therefore, 11β-HSD1 is a promising pharmaceutical target for the treatment of the metabolic syndrome (Masuzaki, et al., (2003) Curr. Drug Targets Immune Endocr. Metabol. Disord. 3: 255-62). Furthermore, inhibition of 1113-HSD1 activity may prove beneficial in treating numerous glucocorticoid-related disorders. For example, 11β-HSD1 inhibitors could be effective in combating obesity and/or aspects of the metabolic syndrome cluster, including glucose intolerance, insulin resistance, hyperglycemia, hypertension, and/or hyperlipidemia (Kotelevstev et al. (1997) Proc. Natl. Acad. Sci. 94: 14924-14929; Morton et al. (2001) J. Biol. Chem. 276: 41293-41300; Morton et al. (2004) Diabetes 53: 931-938). In addition, inhibition of 11β-HSD1 activity may have beneficial effects on the pancreas, including the enhancement of glucose-stimulated insulin release (Billaudel and Sutter (1979) Horm. Metab. Res. 11: 555-560; Ogawa et al. (1992) J. Clin. Invest. 90: 497-504; Davani et al. (2000) J. Biol. Chem. 275: 34841-34844).

Furthermore, given that inter-individual differences in general cognitive function have been linked to variability in the long-term exposure to glucocorticoids (Lupien et al. (1998) Nat. Neurosci. 1: 69-73) and dysregulation of the HPA axis resulting in chronic exposure to glucocorticoid excess in certain brain subregions has been theorized to contribute to the decline of cognitive function (McEwen and Sapolsky (1995) Curr. Opin. Neurobiol. 5: 205-216), one might predict that inhibition of 11β-HSD1 could reduce exposure to glucocorticoids in the brain and thereby protect against deleterious glucocorticoid effects on neuronal function, including cognitive impairment, dementia, and/or depression. Notably, it is known that stress and glucocorticoids influence cognitive function (de Quervain et al. (1998) Nature 394: 787-790); and it has been shown that 11β-HSD1, through its control of glucocorticoid action in the brain, may have effects on neurotoxicity (Rajan et al. (1996) Neuroscience 16: 65-70; Seckl (2000) Neuroendocrinol. 18:49-99).

There is also evidence that glucocorticoids and 11β-HSD1 play a role in regulation of in intra-ocular pressure (IOP) (Stokes et al. (2000) Invest. Ophthalmol. Vis. Sci. 41: 1629-1683; Rauz et al. (2001) Invest. Ophthalmol. Vis. Sci. 42: 2037-2042); if left untreated, elevated IOP can lead to partial visual field loss and eventually blindness. Thus, inhibition of 11β-HSD1 in the eye could reduce local glucocorticoid concentrations and IOP, and 11β-HSD1 hence could potentially be used to treat glaucoma and other visual disorders.

Transgenic aP2-11βHSD1 mice exhibit high arterial blood pressure and have increased sensitivity to dietary salt. Moreover, plasma angiotensinogen levels are elevated in the transgenic mice, as are angiotensin II and aldosterone; and treatment of the mice with an angiotensin II antagonist alleviates the hypertension (Masuzaki et al. (2003) J. Clinical Invest. 112: 83-90). This suggests that hypertension may be caused or exacerbated by 11β-HSD1 activity. Thus, 11β-HSD1 inhibitors may be useful for treatment of hypertension and hypertension-related cardiovascular disorders Inhibition of 11β-HSD1 in mature adipocytes is also expected to attenuate secretion of plasminogen activator inhibitor 1 (PAI-1), which is an independent cardiovascular risk factor (Halleux et al. (1999) J. Clin. Endocrinol. Metabl. 84: 4097-4105).

Glucocorticoids can have adverse effects on skeletal tissues; and prolonged exposure to even moderate glucocorticoid doses can result in osteoporosis (Cannalis (1996) J. Clin. Endocrinol. Metab. 81: 3441-3447). In addition, 11β-HSD1 has been shown to be present in cultures of human primary osteoblasts as well as cells from adult bone (Cooper et al. (2000) Bone 27: 375-381), and the 11β-HSD1 inhibitor carbenoxolone has been shown to attenuate the negative effects of glucocorticoids on bone nodule formation (Bellows et al. (1998) Bone 23: 119-125). Thus, inhibition of 11β-HSD1 is predicted to decrease the local glucocorticoid concentration within osteoblasts and osteoclasts, thereby producing beneficial effects in various forms of bone disease, including osteoporosis.

11β-HSD1 inhibitors may also be useful for immunomodulation. Although glucocorticoids are perceived to suppress the immune system, in actuality, there is a complex, dynamic interaction between the HPA axis and the immune system (Rook (1999) Baillier's Clin. Endocrinol. Metabl. 13: 576-581). Glucocorticoids play a role in modulating the balance between cell-mediated and humoral immune response, with high glucocorticoid activity normally associated with a humoral response Inhibition of 11β-HSD1 therefore can be used a means of shifting the immune response towards a cell-mediated response. Certain disease states, such as tuberculosis, leprosy (Hansen's disease) and psoriasis, trigger immune responses that are biased towards a humoral response whereas the more effective immune response may be a cell-mediated response. Hence, 11β-HSD1 inhibitors may be useful for treating such diseases.

It has been reported that glucocorticoids inhibit wound healing, especially in diabetic patients with ulcers (Bitar et al. (1999) J. Surg. Res. 82: 234-243; Bitar et al. (1999) Surgery 125: 594-601; Bitar (2000) Surgery 127: 687-695; Bitar (1998) Am. J. Pathol. 152: 547-554). Patients that exhibit impaired glucose tolerance and/or type 2 diabetes often also have impaired wound healing. Glucocorticoids have been shown to increase the risk of infection and delay wound healing (Anstead (1998) Adv. Wound Care 11:277-285). Moreover, there is a correlation between elevated levels of cortisol in wound fluid and non-healing wounds (EP Patent App. No. 0 902 288). Recent published patent applications have suggested that certain 11β-HSD1 inhibitors may be useful for promoting wound healing (PCT/US2006/043,951).

As evidenced herein, there is a continuing need for new and improved drugs that inhibit 11β-HSD1. The novel compounds of the instant invention are effective inhibitors of 11β-HSD1.

SUMMARY OF THE INVENTION

It has now been found that compounds of Formula I or pharmaceutically acceptable salts or prodrugs thereof, are effective inhibitors of 11β-HSD1. In a first embodiment, the invention is a compound represented by Formula I:

wherein variables are defined herein as follows:

-   R¹ is (a) absent or (b) is selected from (C₁-C₆)alkyl,     (C₁-C₆)cycloalkyl, (C₂-C₆)alkenyl, (C₂-C₆)alkynyl,     (C₁-C₃)alkoxy(C₁-C₃)alkoxy, or (C₁-C₃)alkoxy(C₁-C₃)alkyl and is     optionally substituted with up to four groups independently selected     from fluorine, cyano, oxo, R⁴, R⁴O—, (R⁴)₂N—, R⁴O₂C—, R⁴S, R⁴S(═O)—,     R⁴S(═O)₂—, R⁴C(═O)NR⁴—, (R⁴)₂NC(═O)—, (R⁴)₂NC(═O)O—,     (R⁴)₂NC(═O)NR⁴—, R⁴OC(═O)NR⁴—, (R⁴)₂NC(═NCN)NR⁴—, (R⁴O)₂P(═O)O—,     (R⁴O)₂P(═O)NR⁴—, R⁴OS(═O)₂NR⁴—, (R⁴)₂NS(═O)₂O—, (R⁴)₂NS(═O)₂NR⁴—,     R⁴S(═O)₂NR⁴—, R⁴S(═O)₂NHC(═O)—, R⁴S(═O)₂NHC(═O)O—,     R⁴S(═O)₂NHC(═O)NR⁴—, R⁴OS(═O)₂NHC(═O)—, R⁴OS(═O)₂NHC(═O)O—,     R⁴OS(═O)₂NHC(═O)NR⁴—, (R⁴)₂NS(═O)₂NHC(═O)—, (R⁴)₂NS(═O)₂NHC(═O)O—,     (R⁴)₂NS(═O)₂NHC(═O)NR⁴—, R⁴C(═O)NHS(═O)₂—, R⁴C(═O)NHS(═O)₂O—,     R⁴C(═O)NHS(═O)₂NR⁴—, R⁴OC(═O)NHS(═O)₂—, R⁴OC(═O)NHS(═O)₂O—,     R⁴OC(═O)NHS(═O)₂NR⁴—, (R⁴)₂NC(═O)NHS(═O)₂—, (R⁴)₂NC(═O)NHS(═O)₂O—,     (R⁴)₂NC(═O)NHS(═O)₂NR⁴—, heterocyclyl, heteroaryl, arylamino and     heteroarylamino; -   A¹ is (a) a bond, or (b) (C₁-C₃)alkylene, CH₂CH₂O, wherein the     oxygen is attached to Cy¹, or CH₂C(═O), wherein the carbonyl carbon     is attached to Cy¹; -   Cy¹ is aryl, heteroaryl, monocyclic cycloalkyl or monocyclic     heterocyclyl and is optionally substituted with 1 to 4 groups     independently selected from fluorine, chlorine, bromine, iodine,     cyano, nitro, amino, hydroxy, carboxy, (C₁-C₆)alkyl,     hydroxy(C₁-C₆)alkyl, (C₃-C₆)cycloalkyl, hydroxy(C₃-C₆)cycloalkyl,     (C₄-C₇)cycloalkylalkyl, (C₂-C₆)alkenyl, halo(C₂-C₆)alkenyl,     hydroxy(C₂-C₆)alkenyl, (C₂-C₆)alkynyl,     (C₃-C₆)cycloalkyl(C₂-C₄)alkynyl, halo(C₁-C₆)alkyl,     halo(C₃-C₆)cycloalkyl, halo(C₄-C₇)cycloalkylalkyl, (C₁-C₆)alkoxy,     (C₃-C₆)cycloalkoxy, (C₄-C₇)cycloalkylalkoxy, halo(C₁-C₆)alkoxy,     halo(C₃-C₆)cycloalkoxy, halo(C₄-C₇)cycloalkylalkoxy,     (C₁-C₆)alkylthio, (C₃-C₆)cycloalkythio, (C₄-C₇)cycloalkylalkylthio,     halo(C₁-C₆)alkylthio, halo(C₃-C₆)cycloalkythio,     halo(C₄-C₇)cycloalkylalkylthio, (C₁-C₆)alkanesulfinyl,     (C₃-C₆)cycloalkanesulfinyl, (C₄-C₇)cycloalkylalkanesulfinyl,     halo(C₁-C₆)alkanesulfinyl, halo(C₃-C₆)cycloalkanesulfinyl,     halo(C₄-C₇)cycloalkylalkanesulfinyl, (C₁-C₆)alkanesulfonyl,     (C₃-C₆)cycloalkanesulfonyl, (C₄-C₇)cycloalkylalkanesulfonyl,     halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl,     halo(C₄-C₇)cycloalkylalkanesulfonyl, (C₁-C₆)alkylamino,     di(C₁-C₆)alkylamino, (C₁-C₆)alkoxy(C₁-C₆)alkoxy,     halo(C₁-C₆)alkoxy(C₁-C₆)alkoxy, (C₁-C₆)alkoxycarbonyl, H₂NCO,     H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl,     (C₁-C₃)alkoxy(C₁-C₃)alkylaminocarbonyl, heterocyclylcarbonyl,     (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl,     heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino,     (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkylsulfonylamino,     (C₁-C₆)alkylsulfonylamino(C₁-C₆)alkyl,     (C₁-C₆)alkoxycarbonyl(C₁-C₆)alkoxy, (C₁-C₆)alkoxy(C₁-C₆)alkyl,     halo(C₁-C₆)alkoxy(C₁-C₆)alkyl, hydroxy(C₁-C₆)alkoxy, heteroaryl,     oxo, amino(C₁-C₆)alkyl, (C₁-C₆)alkylamino(C₁-C₆)alkyl,     di(C₁-C₆)alkylamino(C₁-C₆)alkyl amino(C₂-C₆)alkoxy,     (C₁-C₆)alkylamino(C₂-C₆)alkoxy, di(C₁-C₆)alkylamino(C₂-C₆)alkoxy,     (C₁-C₆)alkylcarbonyl, (C₃-C₆)cycloalkylcarbonyl,     (C₃-C₆)cycloalkylaminocarbonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl,     di(C₃-C₆)cycloalkylaminocarbonyl, (C₃-C₆)cycloalkylaminosulfonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminosulfonyl,     di(C₃-C₆)cycloalkylaminosulfonyl, cyano(C₁-C₆)alkyl,     aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     (C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl(C₁-C₆)alkyl and     di(C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl; -   Cy² is benzimidazolyl, benzotriazolyl and piperidinyl and is     optionally substituted with 1 to 4 groups independently selected     from fluorine, chlorine, bromine, iodine, cyano, nitro, amino,     hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl,     (C₃-C₆)cycloalkyl, hydroxy(C₃-C₆)cycloalkyl, (C₄-C₇)cycloalkylalkyl,     (C₂-C₆)alkenyl, halo(C₂-C₆)alkenyl, hydroxy(C₂-C₆)alkenyl,     (C₂-C₆)alkynyl, (C₃-C₆)cycloalkyl(C₂-C₄)alkynyl, halo(C₁-C₆)alkyl,     halo(C₃-C₆)cycloalkyl, halo(C₄-C₇)cycloalkylalkyl, (C₁-C₆)alkoxy,     (C₃-C₆)cycloalkoxy, (C₄-C₇)cycloalkylalkoxy, halo(C₁-C₆)alkoxy,     halo(C₃-C₆)cycloalkoxy, halo(C₄-C₇)cycloalkylalkoxy,     (C₁-C₆)alkylthio, (C₃-C₆)cycloalkythio, (C₄-C₇)cycloalkylalkylthio,     halo(C₁-C₆)alkylthio, halo(C₃-C₆)cycloalkythio,     halo(C₄-C₇)cycloalkylalkylthio, (C₁-C₆)alkanesulfinyl,     (C₃-C₆)cycloalkanesulfinyl, (C₄-C₇)cycloalkylalkanesulfinyl,     halo(C₁-C₆)alkanesulfinyl, halo(C₃-C₆)cycloalkanesulfinyl,     halo(C₄-C₇)cycloalkylalkanesulfinyl, (C₁-C₆)alkanesulfonyl,     (C₃-C₆)cycloalkanesulfonyl, (C₄-C₇)cycloalkylalkanesulfonyl,     halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl,     halo(C₄-C₇)cycloalkylalkanesulfonyl, (C₁-C₆)alkylamino,     di(C₁-C₆)alkylamino, (C₁-C₆)alkoxy(C₁-C₆)alkoxy,     halo(C₁-C₆)alkoxy(C₁-C₆)alkoxy, (C₁-C₆)alkoxycarbonyl, H₂NCO,     H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl,     (C₁-C₃)alkoxy(C₁-C₃)alkylaminocarbonyl, heterocyclylcarbonyl,     (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl,     heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino,     (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkylsulfonylamino,     (C₁-C₆)alkylsulfonylamino(C₁-C₆)alkyl,     (C₁-C₆)alkoxycarbonyl(C₁-C₆)alkoxy, (C₁-C₆)alkoxy(C₁-C₆)alkyl,     halo(C₁-C₆)alkoxy(C₁-C₆)alkyl, hydroxy(C₁-C₆)alkoxy, heteroaryl,     oxo, amino(C₁-C₆)alkyl, (C₁-C₆)alkylamino(C₁-C₆)alkyl,     di(C₁-C₆)alkylamino(C₁-C₆)alkylamino(C₂-C₆)alkoxy,     (C₁-C₆)alkylamino(C₂-C₆)alkoxy, di(C₁-C₆)alkylamino(C₂-C₆)alkoxy,     (C₁-C₆)alkylcarbonyl, hydroxy(C₁-C₆)alkylcarbonyl,     (C₃-C₆)cycloalkylcarbonyl, (C₃-C₆)cycloalkylaminocarbonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl,     di(C₃-C₆)cycloalkylaminocarbonyl, (C₃-C₆)cycloalkylaminosulfonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminosulfonyl,     di(C₃-C₆)cycloalkylaminosulfonyl, cyano(C₁-C₆)alkyl,     aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     (C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl(C₁-C₆)alkyl and     di(C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl; wherein the     piperidinyl represented by Cy¹ is attached to Cy¹ through a ring     carbon atom. In another embodiment, when Cy² is piperidinyl, oxo is     also a possible substituent. -   Alternatively, when R³ is methoxymethyl, Cy² is (a) halogen or     —O—SO₃—R or (b) cycloalkyl, aryl, heterocyclyl or heteroaryl,     optionally substituted with 1 to 4 groups independently selected     from fluorine, chlorine, bromine, iodine, cyano, nitro, amino,     hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl,     (C₃-C₆)cycloalkyl, hydroxy(C₃-C₆)cycloalkyl,     (C₃-C₇)cycloalkyl(C₁-C₂)alkyl, (C₂-C₆)alkenyl, halo(C₂-C₆)alkenyl,     hydroxy(C₂-C₆)alkenyl, (C₂-C₆)alkynyl,     (C₃-C₆)cycloalkyl(C₂-C₄)alkynyl, halo(C₁-C₆)alkyl,     halo(C₃-C₆)cycloalkyl, halo(C₃-C₇)cycloalkyl(C₁-C₂)alkyl,     (C₁-C₆)alkoxy, (C₃-C₆)cycloalkoxy, (C₃-C₇)cycloalkyl(C₁-C₂)alkoxy,     halo(C₁-C₆)alkoxy, halo(C₃-C₆)cyclo alkoxy, halo(C₃-C₇)cyclo     alkyl(C₁-C₂)alkoxy, (C₁-C₆)alkylthio, (C₃-C₆)cycloalkythio,     (C₃-C₇)cycloalkyl(C₁-C₂)alkylthio, halo(C₁-C₆)alkylthio,     halo(C₃-C₆)cycloalkythio, halo(C₃-C₇)cycloalkyl(C₁-C₂)alkylthio,     (C₁-C₆)alkanesulfinyl, (C₃-C₆)cycloalkanesulfinyl,     (C₃-C₇)cycloalkyl(C₁-C₂)alkanesulfinyl, halo(C₁-C₆)alkanesulfinyl,     halo(C₃-C₆)cycloalkanesulfinyl,     halo(C₃-C₇)cycloalkyl(C₁-C₂)alkanesulfinyl, (C₁-C₆)alkanesulfonyl,     (C₃-C₆)cycloalkanesulfonyl, (C₃-C₇)cycloalkyl(C₁-C₂)alkanesulfonyl,     halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl,     halo(C₃-C₇)cycloalkyl(C₁-C₂)alkanesulfonyl, (C₁-C₆)alkylamino,     di(C₁-C₆)alkylamino, (C₁-C₆)alkoxy(C₁-C₆)alkoxy,     halo(C₁-C₆)alkoxy(C₁-C₆)alkoxy, (C₁-C₆)alkoxycarbonyl, H₂NCO,     H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl,     (C₁-C₃)alkoxy(C₁-C₃)alkylaminocarbonyl, heterocyclylcarbonyl,     (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl,     heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino,     (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkylsulfonylamino,     (C₁-C₆)alkylsulfonylamino(C₁-C₆)alkyl,     (C₁-C₆)alkoxycarbonyl(C₁-C₆)alkoxy, (C₁-C₆)alkoxy(C₁-C₆)alkyl,     halo(C₁-C₆)alkoxy(C₁-C₆)alkyl, hydroxy(C₁-C₆)alkoxy, heteroaryl,     amino(C₁-C₆)alkyl, (C₁-C₆)alkylamino(C₁-C₆)alkyl,     di(C₁-C₆)alkylamino(C₁-C₆)alkylamino(C₂-C₆)alkoxy,     (C₁-C₆)alkylamino(C₂-C₆)alkoxy, di(C₁-C₆)alkylamino(C₂-C₆)alkoxy,     (C₁-C₆)alkylcarbonyl, (C₃-C₆)cycloalkylcarbonyl,     (C₃-C₆)cycloalkylaminocarbonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl,     di(C₃-C₆)cycloalkylaminocarbonyl, (C₃-C₆)cycloalkylaminosulfonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminosulfonyl,     di(C₃-C₆)cycloalkylaminosulfonyl, cyano(C₁-C₆)alkyl,     aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     (C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl(C₁-C₆)alkyl and     di(C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl; -   Y is (C₁-C₆)alkyl, halo(C₁-C₆)alkyl or oxo; -   n is 0, 1 or 2; -   E is (a) a bond or (b) (C₁-C₃)alkylene or (C₁-C₂)alkylenyloxy,     wherein the O is attached to R², each of which is optionally     substituted with 1 to 4 groups independently selected from methyl,     ethyl, trifluoromethyl or oxo; -   R² is (C₁-C₆)alkyl, aryl, heteroaryl, cycloalkyl or heterocyclyl and     is optionally substituted with up to 4 groups independently selected     from fluorine, chlorine, bromine, iodine, cyano, nitro, amino,     hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl,     (C₃-C₆)cycloalkyl, hydroxy(C₃-C₆)cycloalkyl, (C₄-C₇)cycloalkylalkyl,     (C₂-C₆)alkenyl, halo(C₂-C₆)alkenyl, hydroxy(C₂-C₆)alkenyl,     (C₂-C₆)alkynyl, (C₃-C₆)cycloalkyl(C₂-C₄)alkynyl, halo(C₁-C₆)alkyl,     halo(C₃-C₆)cycloalkyl, halo(C₄-C₇)cycloalkylalkyl, (C₁-C₆)alkoxy,     (C₃-C₆)cycloalkoxy, (C₄-C₇)cycloalkylalkoxy, halo(C₁-C₆)alkoxy,     halo(C₃-C₆)cycloalkoxy, halo(C₄-C₇)cycloalkylalkoxy,     (C₁-C₆)alkylthio, (C₃-C₆)cycloalkythio, (C₄-C₇)cycloalkylalkylthio,     halo(C₁-C₆)alkylthio, halo(C₃-C₆)cycloalkythio,     halo(C₄-C₇)cycloalkylalkylthio, (C₁-C₆)alkanesulfinyl,     (C₃-C₆)cycloalkanesulfinyl, (C₄-C₇)cycloalkylalkanesulfinyl,     halo(C₁-C₆)alkanesulfinyl, halo(C₃-C₆)cycloalkanesulfinyl,     halo(C₄-C₇)cycloalkylalkanesulfinyl, (C₁-C₆)alkanesulfonyl,     (C₃-C₆)cycloalkanesulfonyl, (C₄-C₇)cycloalkylalkanesulfonyl,     halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl,     halo(C₄-C₇)cycloalkylalkanesulfonyl, (C₁-C₆)alkylamino,     di(C₁-C₆)alkylamino, (C₁-C₆)alkoxy(C₁-C₆)alkoxy,     halo(C₁-C₆)alkoxy(C₁-C₆)alkoxy, (C₁-C₆)alkoxycarbonyl, H₂NCO,     H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl,     (C₁-C₃)alkoxy(C₁-C₃)alkylaminocarbonyl, heterocyclylcarbonyl,     (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl,     heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino,     (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkylsulfonylamino,     (C₁-C₆)alkylsulfonylamino(C₁-C₆)alkyl,     (C₁-C₆)alkoxycarbonyl(C₁-C₆)alkoxy, (C₁-C₆)alkoxy(C₁-C₆)alkyl,     halo(C₁-C₆)alkoxy(C₁-C₆)alkyl, hydroxy(C₁-C₆)alkoxy, heteroaryl,     oxo, amino(C₁-C₆)alkyl, (C₁-C₆)alkylamino(C₁-C₆)alkyl,     di(C₁-C₆)alkylamino(C₁-C₆)alkylamino(C₂-C₆)alkoxy,     (C₁-C₆)alkylamino(C₂-C₆)alkoxy, di(C₁-C₆)alkylamino(C₂-C₆)alkoxy,     (C₁-C₆)alkylcarbonyl, (C₃-C₆)cycloalkylcarbonyl,     (C₃-C₆)cycloalkylaminocarbonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl,     di(C₃-C₆)cycloalkylaminocarbonyl, (C₃-C₆)cycloalkylaminosulfonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminosulfonyl,     di(C₃-C₆)cycloalkylaminosulfonyl, cyano(C₁-C₆)alkyl,     aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     (C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl(C₁-C₆)alkyl and     di(C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl; -   R³ is selected from (C₁-C₆)alkyl, (C₂-C₆)alkenyl, (C₂-C₆)alkynyl,     (C₃-C₅)cycloalkyl(C₁-C₄)alkyl, (C₁-C₃)alkoxy(C₁-C₃)alkoxy, or     (C₁-C₃)alkoxy(C₁-C₃)alkyl and is optionally substituted with up to     four groups independently selected from fluorine, cyano, oxo, R⁴,     R⁴O—, (R⁴)₂N—, R⁴O₂C—, R⁴C(═O)O—, R⁴S, R⁴S(═O)—, R⁴S(═O)₂—,     R⁴C(═O)NR⁴—, (R⁴)₂NC(═O)—, (R⁴)₂NC(═O)O—, (R⁴)₂NC(═O)NR⁴—,     R⁴OC(═O)NR⁴—, (R⁴)₂NC(═NCN)NR⁴—, (R⁴⁰)₂P(═O)O—, (R⁴⁰)₂P(═O)NR⁴—,     R⁴OS(═O)₂NR⁴—, (R⁴)₂NS(═O)₂O—, (R⁴)₂NS(═O)₂NR⁴—, R⁴S(═O)₂NR⁴—,     R⁴S(═O)₂NHC(═O)—, R⁴S(═O)₂NHC(═O)O—, R⁴S(═O)₂NHC(═O)NR⁴—,     R⁴OS(═O)₂NHC(═O)—, R⁴OS(═O)₂NHC(═O)O—, R⁴OS(═O)₂NHC(═O)NR⁴—,     (R⁴)₂NS(═O)₂NHC(═O)—, (R⁴)₂NS(═O)₂NHC(═O)O—,     (R⁴)₂NS(═O)₂NHC(═O)NR⁴—, R⁴C(═O)NHS(═O)₂—, R⁴C(═O)NHS(═O)₂O—,     R⁴C(═O)NHS(═O)₂NR⁴—, R⁴OC(═O)NHS(═O)₂—, R⁴OC(═O)NHS(═O)₂O—,     R⁴OC(═O)NHS(═O)₂NR⁴—, (R⁴)₂NC(═O)NHS(═O)₂—, (R⁴)₂NC(═O)NHS(═O)₂O—,     (R⁴)₂NC(═O)NHS(═O)₂NR⁴—, spirocycloalkyl; heterocyclyl (which in     turn may be optionally substituted with alkyl, haloalkyl, halogen or     oxo), heteroaryl (which in turn may be optionally substituted with     alkyl, haloalkyl, alkoxy, alkylthio, alkylsulfonyl, halogen,     trifluoromethyl, dialkylamino, nitro, cyano, CO₂H, CONH₂,     N-monoalkyl-substituted amido, N,N-dialkyl-substituted amido, or     oxo), arylamino (which in turn may be optionally substituted with     alkyl, alkoxy, alkylthio, alkylsulfonyl, halogen, trifluoromethyl,     dialkylamino, nitro, cyano, CO₂H, CONH₂, N-monoalkyl-substituted     amido and N,N-dialkyl-substituted amido) and heteroarylamino (which     in turn may be optionally substituted with alkyl, haloalkyl, alkoxy,     alkylthio, alkylsulfonyl, halogen, trifluoromethyl, dialkylamino,     nitro, cyano, CO₂H, CONH₂, N-monoalkyl-substituted amido,     N,N-dialkyl-substituted amido, or oxo); and -   R⁴ is independently selected from H, (C₁-C₆)alkyl, halo(C₁-C₆)alkyl,     amino(C₁-C₆)alkyl, (C₁-C₆)alkylamino(C₁-C₆)alkyl,     di(C₁-C₆)alkylamino(C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl and     (C₁-C₆)alkoxy(C₁-C₆)alkyl; and -   R is (i) (C₁-C₄)alkyl optionally substituted with one or more     halogen or (ii) phenyl, optionally substituted with halogen,     (C₁-C₄)alkyl or NO₂;     or a pharmaceutically acceptable salt, enantiomer or diastereomer     thereof.     In a second embodiment, the invention is a compound represented by     Formula I, wherein variables are defined herein as follows: -   R¹ is (a) absent or (b) is selected from (C₁-C₆)alkyl,     (C₂-C₆)alkenyl, (C₂-C₆)alkynyl, (C₁-C₃)alkoxy(C₁-C₃)alkoxy, or     (C₁-C₃)alkoxy(C₁-C₃)alkyl and is optionally substituted with up to     four groups independently selected from fluorine, cyano, oxo, R⁴,     R⁴O—, (R⁴)₂N—, R⁴O₂C—, R⁴S, R⁴S(═O)—, R⁴S(═O)₂—, R⁴C(═O)NR⁴—,     (R⁴)₂NC(═O)—, (R⁴)₂NC(═O)O—, (R⁴)₂NC(═O)NR⁴—, R⁴OC(═O)NR⁴—,     (R⁴)₂NC(═NCN)NR⁴—, (R⁴O)₂P(═O)O—, (R⁴O)₂P(═O)NR⁴—, R⁴OS(═O)₂NR⁴—,     (R⁴)₂NS(═O)₂O—, (R⁴)₂NS(═O)₂NR⁴—, R⁴S(═O)₂NR⁴—, R⁴S(═O)₂NHC(═O)—,     R⁴S(═O)₂NHC(═O)O—, R⁴S(═O)₂NHC(═O)NR⁴—, R⁴OS(═O)₂NHC(═O)—,     R⁴OS(═O)₂NHC(═O)O—, R⁴OS(═O)₂NHC(═O)NR⁴—, (R⁴)₂NS(═O)₂NHC(═O)—,     (R⁴)₂NS(═O)₂NHC(═O)O—, (R⁴)₂NS(═O)₂NHC(═O)NR⁴—, R⁴C(═O)NHS(═O)₂—,     R⁴C(═O)NHS(═O)₂O—, R⁴C(═O)NHS(═O)₂NR⁴—, R⁴OC(═O)NHS(═O)₂—,     R⁴OC(═O)NHS(═O)₂O—, R⁴OC(═O)NHS(═O)₂NR⁴—, (R⁴)₂NC(═O)NHS(═O)₂—,     (R⁴)₂NC(═O)NHS(═O)₂O—, (R⁴)₂NC(═O)NHS(═O)₂NR⁴—, heterocyclyl,     heteroaryl, arylamino and heteroarylamino; -   A¹ is (a) a bond, or (b) (C₁-C₃)alkylene, CH₂CH₂O, wherein the     oxygen is attached to Cy¹, or CH₂C(═O), wherein the carbonyl carbon     is attached to Cy¹; -   Cy¹ is aryl, heteroaryl, monocyclic cycloalkyl or monocyclic     heterocyclyl and is optionally substituted with 1 to 4 groups     independently selected from fluorine, chlorine, bromine, iodine,     cyano, nitro, amino, hydroxy, carboxy, (C₁-C₆)alkyl,     hydroxy(C₁-C₆)alkyl, (C₃-C₆)cycloalkyl, hydroxy(C₃-C₆)cycloalkyl,     (C₄-C₇)cycloalkylalkyl, (C₂-C₆)alkenyl, halo(C₂-C₆)alkenyl,     hydroxy(C₂-C₆)alkenyl, (C₂-C₆)alkynyl,     (C₃-C₆)cycloalkyl(C₂-C₄)alkynyl, halo(C₁-C₆)alkyl,     halo(C₃-C₆)cycloalkyl, halo(C₄-C₇)cycloalkylalkyl, (C₁-C₆)alkoxy,     (C₃-C₆)cycloalkoxy, (C₄-C₇)cycloalkylalkoxy, halo(C₁-C₆)alkoxy,     halo(C₃-C₆)cycloalkoxy, halo(C₄-C₇)cycloalkylalkoxy,     (C₁-C₆)alkylthio, (C₃-C₆)cycloalkythio, (C₄-C₇)cycloalkylalkylthio,     halo(C₁-C₆)alkylthio, halo(C₃-C₆)cycloalkythio,     halo(C₄-C₇)cycloalkylalkylthio, (C₁-C₆)alkanesulfinyl,     (C₃-C₆)cycloalkanesulfinyl, (C₄-C₇)cycloalkylalkanesulfinyl,     halo(C₁-C₆)alkanesulfinyl, halo(C₃-C₆)cycloalkanesulfinyl,     halo(C₄-C₇)cycloalkylalkanesulfinyl, (C₁-C₆)alkanesulfonyl,     (C₃-C₆)cycloalkanesulfonyl, (C₄-C₇)cycloalkylalkanesulfonyl,     halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl,     halo(C₄-C₇)cycloalkylalkanesulfonyl, (C₁-C₆)alkylamino,     di(C₁-C₆)alkylamino, (C₁-C₆)alkoxy(C₁-C₆)alkoxy,     halo(C₁-C₆)alkoxy(C₁-C₆)alkoxy, (C₁-C₆)alkoxycarbonyl, H₂NCO,     H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl,     (C₁-C₃)alkoxy(C₁-C₃)alkylaminocarbonyl, heterocyclylcarbonyl,     (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl,     heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino,     (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkylsulfonylamino,     (C₁-C₆)alkyl-sulfonylamino(C₁-C₆)alkyl,     (C₁-C₆)alkoxycarbonyl(C₁-C₆)alkoxy, (C₁-C₆)alkoxy(C₁-C₆)alkyl,     halo(C₁-C₆)alkoxy(C₁-C₆)alkyl, hydroxy(C₁-C₆)alkoxy, heteroaryl,     oxo, amino(C₁-C₆)alkyl, (C₁-C₆)alkylamino(C₁-C₆)alkyl,     di(C₁-C₆)alkylamino(C₁-C₆)alkyl amino(C₂-C₆)alkoxy,     (C₁-C₆)alkylamino(C₂-C₆)alkoxy, di(C₁-C₆)alkylamino(C₂-C₆)alkoxy,     (C₁-C₆)alkylcarbonyl, (C₃-C₆)cycloalkylcarbonyl,     (C₃-C₆)cycloalkylaminocarbonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl,     di(C₃-C₆)cycloalkylaminocarbonyl, (C₃-C₆)cycloalkylaminosulfonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminosulfonyl,     di(C₃-C₆)cycloalkylaminosulfonyl, cyano(C₁-C₆)alkyl,     aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     (C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl(C₁-C₆)alkyl and     di(C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl; -   Cy² is benzimidazolyl, benzotriazolyl and piperidinyl and is     optionally substituted with 1 to 4 groups independently selected     from fluorine, chlorine, bromine, iodine, cyano, nitro, amino,     hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl,     (C₃-C₆)cycloalkyl, hydroxy(C₃-C₆)cycloalkyl, (C₄-C₇)cycloalkylalkyl,     (C₂-C₆)alkenyl, halo(C₂-C₆)alkenyl, hydroxy(C₂-C₆)alkenyl,     (C₂-C₆)alkynyl, (C₃-C₆)cycloalkyl(C₂-C₄)alkynyl, halo(C₁-C₆)alkyl,     halo(C₃-C₆)cycloalkyl, halo(C₄-C₇)cycloalkylalkyl, (C₁-C₆)alkoxy,     (C₃-C₆)cycloalkoxy, (C₄-C₇)cycloalkylalkoxy, halo(C₁-C₆)alkoxy,     halo(C₃-C₆)cycloalkoxy, halo(C₄-C₇)cycloalkylalkoxy,     (C₁-C₆)alkylthio, (C₃-C₆)cycloalkythio, (C₄-C₇)cycloalkylalkylthio,     halo(C₁-C₆)alkylthio, halo(C₃-C₆)cycloalkythio,     halo(C₄-C₇)cycloalkylalkylthio, (C₁-C₆)alkanesulfinyl,     (C₃-C₆)cycloalkanesulfinyl, (C₄-C₇)cycloalkylalkanesulfinyl,     halo(C₁-C₆)alkanesulfinyl, halo(C₃-C₆)cycloalkanesulfinyl,     halo(C₄-C₇)cycloalkylalkanesulfinyl, (C₁-C₆)alkanesulfonyl,     (C₃-C₆)cycloalkanesulfonyl, (C₄-C₇)cycloalkylalkanesulfonyl,     halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl,     halo(C₄-C₇)cycloalkylalkanesulfonyl, (C₁-C₆)alkylamino,     di(C₁-C₆)alkylamino, (C₁-C₆)alkoxy(C₁-C₆)alkoxy,     halo(C₁-C₆)alkoxy(C₁-C₆)alkoxy, (C₁-C₆)alkoxycarbonyl, H₂NCO,     H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl,     (C₁-C₃)alkoxy(C₁-C₃)alkylaminocarbonyl, heterocyclylcarbonyl,     (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl,     heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino,     (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkylsulfonylamino,     (C₁-C₆)alkylsulfonylamino(C₁-C₆)alkyl,     (C₁-C₆)alkoxycarbonyl(C₁-C₆)alkoxy, (C₁-C₆)alkoxy(C₁-C₆)alkyl,     halo(C₁-C₆)alkoxy(C₁-C₆)alkyl, hydroxy(C₁-C₆)alkoxy, heteroaryl,     oxo, amino(C₁-C₆)alkyl, (C₁-C₆)alkylamino(C₁-C₆)alkyl,     di(C₁-C₆)alkylamino(C₁-C₆)alkylamino(C₂-C₆)alkoxy,     (C₁-C₆)alkylamino(C₂-C₆)alkoxy, di(C₁-C₆)alkylamino(C₂-C₆)alkoxy,     (C₁-C₆)alkylcarbonyl, (C₃-C₆)cycloalkylcarbonyl,     (C₃-C₆)cycloalkylaminocarbonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl,     di(C₃-C₆)cycloalkylaminocarbonyl, (C₃-C₆)cycloalkylaminosulfonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminosulfonyl,     di(C₃-C₆)cycloalkylaminosulfonyl, cyano(C₁-C₆)alkyl,     aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     (C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl(C₁-C₆)alkyl and     di(C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl; wherein the     piperidinyl represented by Cy¹ is attached to Cy¹ through a ring     carbon atom. In another embodiment, when Cy² is piperidinyl, oxo is     also a possible substituent. -   Alternatively, when R³ is methoxymethyl, Cy² is (a) halogen or     —O—SO₃—R or (b) cycloalkyl, aryl, heterocyclyl or heteroaryl,     optionally substituted with 1 to 4 groups independently selected     from fluorine, chlorine, bromine, iodine, cyano, nitro, amino,     hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl,     (C₃-C₆)cycloalkyl, hydroxy(C₃-C₆)cycloalkyl,     (C₃-C₇)cycloalkyl(C₁-C₂)alkyl, (C₂-C₆)alkenyl, halo(C₂-C₆)alkenyl,     hydroxy(C₂-C₆)alkenyl, (C₂-C₆)alkynyl,     (C₃-C₆)cycloalkyl(C₂-C₄)alkynyl, halo(C₁-C₆)alkyl,     halo(C₃-C₆)cycloalkyl, halo(C₃-C₇)cycloalkyl(C₁-C₂)alkyl,     (C₁-C₆)alkoxy, (C₃-C₆)cycloalkoxy, (C₃-C₇)cycloalkyl(C₁-C₂)alkoxy,     halo(C₁-C₆)alkoxy, halo(C₃-C₆)cyclo alkoxy, halo(C₃-C₇)cyclo     alkyl(C₁-C₂)alkoxy, (C₁-C₆)alkylthio, (C₃-C₆)cycloalkythio,     (C₃-C₇)cycloalkyl(C₁-C₂)alkylthio, halo(C₁-C₆)alkylthio,     halo(C₃-C₆)cycloalkythio, halo(C₃-C₇)cycloalkyl(C₁-C₂)alkylthio,     (C₁-C₆)alkanesulfinyl, (C₃-C₆)cycloalkanesulfinyl,     (C₃-C₇)cycloalkyl(C₁-C₂)alkanesulfinyl, halo(C₁-C₆)alkanesulfinyl,     halo(C₃-C₆)cycloalkanesulfinyl,     halo(C₃-C₇)cycloalkyl(C₁-C₂)alkanesulfinyl, (C₁-C₆)alkanesulfonyl,     (C₃-C₆)cycloalkanesulfonyl, (C₃-C₇)cycloalkyl(C₁-C₂)alkanesulfonyl,     halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl,     halo(C₃-C₇)cycloalkyl(C₁-C₂)alkanesulfonyl, (C₁-C₆)alkylamino,     di(C₁-C₆)alkylamino, (C₁-C₆)alkoxy(C₁-C₆)alkoxy,     halo(C₁-C₆)alkoxy(C₁-C₆)alkoxy, (C₁-C₆)alkoxycarbonyl, H₂NCO,     H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl,     (C₁-C₃)alkoxy(C₁-C₃)alkylaminocarbonyl, heterocyclylcarbonyl,     (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl,     heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino,     (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkylsulfonylamino,     (C₁-C₆)alkylsulfonylamino(C₁-C₆)alkyl,     (C₁-C₆)alkoxycarbonyl(C₁-C₆)alkoxy, (C₁-C₆)alkoxy(C₁-C₆)alkyl,     halo(C₁-C₆)alkoxy(C₁-C₆)alkyl, hydroxy(C₁-C₆)alkoxy, heteroaryl,     amino(C₁-C₆)alkyl, (C₁-C₆)alkylamino(C₁-C₆)alkyl,     di(C₁-C₆)alkylamino(C₁-C₆)alkylamino(C₂-C₆)alkoxy,     (C₁-C₆)alkylamino(C₂-C₆)alkoxy, di(C₁-C₆)alkylamino(C₂-C₆)alkoxy,     (C₁-C₆)alkylcarbonyl, (C₃-C₆)cycloalkylcarbonyl,     (C₃-C₆)cycloalkylaminocarbonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl,     di(C₃-C₆)cycloalkylaminocarbonyl, (C₃-C₆)cycloalkylaminosulfonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminosulfonyl,     di(C₃-C₆)cycloalkylaminosulfonyl, cyano(C₁-C₆)alkyl,     aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     (C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl(C₁-C₆)alkyl and     di(C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl; -   Y is (C₁-C₆)alkyl, halo(C₁-C₆)alkyl or oxo; -   n is 0, 1 or 2; -   E is (a) a bond or (b) (C₁-C₃)alkylene or (C₁-C₂)alkylenyloxy,     wherein the O is attached to R², each of which is optionally     substituted with 1 to 4 groups independently selected from methyl,     ethyl, trifluoromethyl or oxo; -   R² is (C₁-C₆)alkyl, aryl, heteroaryl, cycloalkyl or heterocyclyl and     is optionally substituted with up to 4 groups independently selected     from fluorine, chlorine, bromine, iodine, cyano, nitro, amino,     hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl,     (C₃-C₆)cycloalkyl, hydroxy(C₃-C₆)cycloalkyl, (C₄-C₇)cycloalkylalkyl,     (C₂-C₆)alkenyl, halo(C₂-C₆)alkenyl, hydroxy(C₂-C₆)alkenyl,     (C₂-C₆)alkynyl, (C₃-C₆)cycloalkyl(C₂-C₄)alkynyl, halo(C₁-C₆)alkyl,     halo(C₃-C₆)cycloalkyl, halo(C₄-C₇)cycloalkylalkyl, (C₁-C₆)alkoxy,     (C₃-C₆)cycloalkoxy, (C₄-C₇)cycloalkylalkoxy, halo(C₁-C₆)alkoxy,     halo(C₃-C₆)cycloalkoxy, halo(C₄-C₇)cycloalkylalkoxy,     (C₁-C₆)alkylthio, (C₃-C₆)cycloalkythio, (C₄-C₇)cycloalkylalkylthio,     halo(C₁-C₆)alkylthio, halo(C₃-C₆)cycloalkythio,     halo(C₄-C₇)cycloalkylalkylthio, (C₁-C₆)alkanesulfinyl,     (C₃-C₆)cycloalkanesulfinyl, (C₄-C₇)cycloalkylalkanesulfinyl,     halo(C₁-C₆)alkanesulfinyl, halo(C₃-C₆)cycloalkanesulfinyl,     halo(C₄-C₇)cycloalkylalkanesulfinyl, (C₁-C₆)alkanesulfonyl,     (C₃-C₆)cycloalkanesulfonyl, (C₄-C₇)cycloalkylalkanesulfonyl,     halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl,     halo(C₄-C₇)cycloalkylalkanesulfonyl, (C₁-C₆)alkylamino,     di(C₁-C₆)alkylamino, (C₁-C₆)alkoxy(C₁-C₆)alkoxy,     halo(C₁-C₆)alkoxy(C₁-C₆)alkoxy, (C₁-C₆)alkoxycarbonyl, H₂NCO,     H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl,     (C₁-C₃)alkoxy(C₁-C₃)alkylaminocarbonyl, heterocyclylcarbonyl,     (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl,     heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino,     (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkylsulfonylamino,     (C₁-C₆)alkylsulfonylamino(C₁-C₆)alkyl,     (C₁-C₆)alkoxycarbonyl(C₁-C₆)alkoxy, (C₁-C₆)alkoxy(C₁-C₆)alkyl,     halo(C₁-C₆)alkoxy(C₁-C₆)alkyl, hydroxy(C₁-C₆)alkoxy, heteroaryl,     oxo, amino(C₁-C₆)alkyl, (C₁-C₆)alkylamino(C₁-C₆)alkyl,     di(C₁-C₆)alkylamino(C₁-C₆)alkylamino(C₂-C₆)alkoxy,     (C₁-C₆)alkylamino(C₂-C₆)alkoxy, di(C₁-C₆)alkylamino(C₂-C₆)alkoxy,     (C₁-C₆)alkylcarbonyl, (C₃-C₆)cycloalkylcarbonyl,     (C₃-C₆)cycloalkylaminocarbonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl,     di(C₃-C₆)cycloalkylaminocarbonyl, (C₃-C₆)cycloalkylaminosulfonyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminosulfonyl,     di(C₃-C₆)cycloalkylaminosulfonyl, cyano(C₁-C₆)alkyl,     aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl,     di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl, (C₃-C₆)cyclo     alkylaminocarbonyl(C₁-C₆)alkyl,     {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl(C₁-C₆)alkyl and     di(C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl; -   R³ is selected from (C₁-C₆)alkyl, (C₂-C₆)alkenyl, (C₂-C₆)alkynyl,     (C₃-C₅)cycloalkyl(C₁-C₄)alkyl, (C₁-C₃)alkoxy(C₁-C₃)alkoxy, or     (C₁-C₃)alkoxy(C₁-C₃)alkyl and is optionally substituted with up to     four groups independently selected from fluorine, cyano, oxo, R⁴,     R⁴O—, (R⁴)₂N—, R⁴O₂C—, R⁴C(═O)O—, R⁴S, R⁴S(═O)—, R⁴S(═O)₂—,     R⁴C(═O)NR⁴—, (R⁴)₂NC(═O)—, (R⁴)₂NC(═O)O—, (R⁴)₂NC(═O)NR⁴—,     R⁴OC(═O)NR⁴—, (R⁴)₂NC(═NCN)NR⁴—, (R⁴O)₂P(═O)O—, (R⁴O)₂P(═O)NR⁴—,     R⁴OS(═O)₂NR⁴—, (R⁴)₂NS(═O)₂O—, (R⁴)₂NS(═O)₂NR⁴—, R⁴S(═O)₂NR⁴—,     R⁴S(═O)₂NHC(═O)—, R⁴S(═O)₂NHC(═O)O—, R⁴S(═O)₂NHC(═O)NR⁴—,     R⁴OS(═O)₂NHC(═O)—, R⁴OS(═O)₂NHC(═O)O—, R⁴OS(═O)₂NHC(═O)NR⁴—,     (R⁴)₂NS(═O)₂NHC(═O)—, (R⁴)₂NS(═O)₂NHC(═O)O—,     (R⁴)₂NS(═O)₂NHC(═O)NR⁴—, R⁴C(═O)NHS(═O)₂—, R⁴C(═O)NHS(═O)₂O—,     R⁴C(═O)NHS(═O)₂NR⁴—, R⁴OC(═O)NHS(═O)₂—, R⁴OC(═O)NHS(═O)₂O—,     R⁴OC(═O)NHS(═O)₂NR⁴—, (R⁴)₂NC(═O)NHS(═O)₂—, (R⁴)₂NC(═O)NHS(═O)₂O—,     (R⁴)₂NC(═O)NHS(═O)₂NR⁴—, spirocycloalkyl; heterocyclyl (which in     turn may be optionally substituted with alkyl, haloalkyl, halogen or     oxo), heteroaryl (which in turn may be optionally substituted with     alkyl, haloalkyl, alkoxy, alkylthio, alkylsulfonyl, halogen,     trifluoromethyl, dialkylamino, nitro, cyano, CO₂H, CONH₂,     N-monoalkyl-substituted amido, N,N-dialkyl-substituted amido, or     oxo), arylamino (which in turn may be optionally substituted with     alkyl, alkoxy, alkylthio, alkylsulfonyl, halogen, trifluoromethyl,     dialkylamino, nitro, cyano, CO₂H, CONH₂, N-monoalkyl-substituted     amido and N,N-dialkyl-substituted amido) and heteroarylamino (which     in turn may be optionally substituted with alkyl, haloalkyl, alkoxy,     alkylthio, alkylsulfonyl, halogen, trifluoromethyl, dialkylamino,     nitro, cyano, CO₂H, CONH₂, N-monoalkyl-substituted amido,     N,N-dialkyl-substituted amido, or oxo); and -   R⁴ is independently selected from H, (C₁-C₆)alkyl, halo(C₁-C₆)alkyl,     amino(C₁-C₆)alkyl, (C₁-C₆)alkylamino(C₁-C₆)alkyl,     di(C₁-C₆)alkylamino(C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl and     (C₁-C₆)alkoxy(C₁-C₆)alkyl; and -   R is (i) (C₁-C₄)alkyl optionally substituted with one or more     halogen or (ii) phenyl, optionally substituted with halogen,     (C₁-C₄)alkyl or NO₂;     or a pharmaceutically acceptable salt, enantiomer or diastereomer     thereof.

Another embodiment of the invention is a method of inhibiting 11β-HSD1 activity comprising the step of administering to a mammal in need of such treatment an effective amount of a compound of Formulas I, Ia¹⁻¹⁰, Ib¹⁻¹⁰, Ic¹⁻¹⁰, Id¹⁻⁷ or Ie¹⁻⁵ or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof.

Another embodiment of the invention is a method of treating a subject with a disease associated with the activity or expression of 11β-HSD1, comprising the step of administering to the subject an effective amount of a compound of Formulas I, Ia¹⁻¹⁰, Ib¹⁻¹⁰, Ic¹⁻¹⁰, Id¹⁻⁷ or Ie¹⁻⁵ or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof.

Another embodiment of the invention is the use of a compound of Formulas I, Ia¹⁻¹⁰, Ib¹⁻¹⁰, Ic¹⁻¹⁰, Id¹⁻⁷ or Ie¹⁻⁵ or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof for the manufacture of a medicament for inhibiting 11β-HSD1 activity in a mammal in need of such treatment.

Another embodiment of the invention is the use of a compound of Formulas I, Ia¹⁻¹⁰, Ib¹⁻¹⁰, Ic¹⁻¹⁰, Id¹⁻⁷ or Ie¹⁻⁵ or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof for the manufacture of a medicament for treating a subject with a disease associated with the activity or expression of 11β-HSD1.

Another embodiment of the invention is a compound of Formulas I, Ia¹⁻¹⁰, Ib¹⁻¹⁰, Ic¹⁻¹⁰, Id¹⁻⁷ or Ie¹⁻⁵ or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof for use in inhibiting 11β-HSD1 activity in a mammal in need of such treatment.

Another embodiment of the invention is a compound of Formulas I, Ia¹⁻¹⁰, Ib¹⁻¹⁰, Ic¹⁻¹⁰, Id¹⁻⁷ or Ie¹⁻⁵ or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof for use in for treating a subject with a disease associated with the activity or expression of 11β-HSD1.

Another embodiment of the present invention is a pharmaceutical composition comprising: i) a pharmaceutically acceptable carrier or diluent; and ii) compound of Formulas I, Ia¹⁻¹⁰, Ib¹⁻¹⁰, Ic¹⁻¹⁰, Id¹⁻⁷ or Ie¹⁻⁵ or a pharmaceutically acceptable salt, enantiomer or diastereomer, thereof.

DETAILED DESCRIPTION OF THE INVENTION

In a third embodiment, the variables in Formula I:

R¹ is (a) absent or (b) (C₁-C₆)alkyl or (C₁-C₆)cycloalkyl and is optionally substituted with up to four groups independently selected from fluorine, cyano, oxo, R⁴, R⁴O—, (R⁴)₂N—, R⁴O₂C—, R⁴S, R⁴S(═O)—, R⁴S(═O)₂—, R⁴C(═O)NR⁴—, (R⁴)₂NC(═O)—, (R⁴)₂NC(═O)O—, (R⁴)₂NC(═O)NR⁴—, R⁴OC(═O)NR⁴—, (R⁴)₂NS(═O)₂NR⁴— and R⁴S(═O)₂NR⁴—.

A¹ is (a) a bond, (b) (C₁-C₂)alkylene, or (c) CH if R¹ is present.

n is 0.

E is a bond or CH₂.

R² is (C₁-C₆)alkyl, aryl, heteroaryl, cycloalkyl or heterocyclyl and is optionally substituted with up to 4 groups independently selected from fluorine, chlorine, bromine, iodine, cyano, nitro, amino, hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl, (C₃-C₆)cycloalkyl, hydroxy(C₃-C₆)cycloalkyl, halo(C₁-C₆)alkyl, (C₁-C₆)alkoxy, (C₃-C₆)cycloalkoxy, halo(C₁-C₆)alkoxy, (C₁-C₆)alkanesulfonyl, halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl, H₂NCO, H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl, heterocyclylcarbonyl, (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl, heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino, (C₁-C₆)alkyl-carbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkylsulfonylamino and oxo.

R³ is selected from (C₁-C₆)alkyl, (C₂-C₆)alkenyl, (C₂-C₆)alkynyl, (C₃-C₅)cycloalkyl(C₁-C₄)alkyl, (C₁-C₃)alkoxy(C₁-C₃)alkoxy, or (C₁-C₃)alkoxy(C₁-C₃)alkyl and is optionally substituted with up to four groups independently selected from fluorine, cyano, oxo, R⁴, R⁴⁰—, R⁴S—, (R⁴)₂N—, R⁴OCR⁴ ₂CR⁴ ₂NR⁴—, R⁴OCR⁴ ₂C(═O)NR⁴—, R⁴OCR⁴ ₂CR⁴ ₂O—, R⁴O₂C—, R⁴S, R⁴S(═O)—, R⁴S(═O)₂—, R⁴C(═O)NR⁴—, (R⁴)₂NC(═O)—, (R⁴)₂NC(═O)O—, (R⁴)₂NC(═O)NR⁴—, R⁴OC(═O)NR⁴—, (R⁴)₂NS(═O)₂NR⁴—, R⁴S(═O)₂NR⁴—, R⁴ ₂NS(═O)₂O—, (R⁴⁰)₂P(═O)O—, R⁴ ₂NCR⁴ ₂C(═O)NR⁴—, N(R⁴)₂C(═NCN)NR⁴—, R⁴S(═O)₂NR⁴C(═O)—, imidazolylamino-, imidazolyl, tetrazolyl, 4-morpholino, azetidinyl, pyrrolidinyl, fluoropyrrolidinyl, oxopiperazinyl, 1, dioxoisothiazolidinyl, methylimidazolyl, methyloxadiazolyl, methylthiadiazolyl and (1-hydroxycyclopropyl)methyl.

Alternatively, R³ is methoxymethyl.

R⁴ is independently selected from H, (C₁-C₆)alkyl and halo(C₁-C₆)alkyl;

or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof. Values for the remaining variables are as defined above for the first or second embodiment of Formula (I).

In a fourth embodiment, the variables in Formula I:

R¹ is (a) absent or (b) (C₁-C₆)alkyl is optionally substituted with up to four groups independently selected from fluorine, cyano, oxo, R⁴, R⁴O—, (R⁴)₂N—, R⁴O₂C—, R⁴S, R⁴S(═O)—, R⁴S(═O)₂—, R⁴C(═O)NR⁴—, (R⁴)₂NC(═O)—, (R⁴)₂NC(═O)O—, (R⁴)₂NC(═O)NR⁴—, R⁴OC(═O)NR⁴—, (R⁴)₂NS(═O)₂NR⁴— and R⁴S(═O)₂NR⁴—.

A¹ is (a) a bond, (b) (C₁-C₂)alkylene, or (c) CH if R¹ is present.

n is 0.

E is a bond or CH₂.

R² is (C₁-C₆)alkyl, aryl, heteroaryl, cycloalkyl or heterocyclyl and is optionally substituted with up to 4 groups independently selected from fluorine, chlorine, bromine, iodine, cyano, nitro, amino, hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl, (C₃-C₆)cycloalkyl, hydroxy(C₃-C₆)cycloalkyl, halo(C₁-C₆)alkyl, (C₁-C₆)alkoxy, (C₃-C₆)cycloalkoxy, halo(C₁-C₆)alkoxy, (C₁-C₆)alkanesulfonyl, halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl, H₂NCO, H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl, heterocyclylcarbonyl, (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl, heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino, (C₁-C₆)alkyl-carbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkylsulfonylamino and oxo.

R³ is selected from (C₁-C₆)alkyl, (C₂-C₆)alkenyl, (C₂-C₆)alkynyl, (C₃-C₅)cycloalkyl(C₁-C₄)alkyl, (C₁-C₃)alkoxy(C₁-C₃)alkoxy, or (C₁-C₃)alkoxy(C₁-C₃)alkyl and is optionally substituted with up to four groups independently selected from fluorine, cyano, oxo, R⁴, R⁴O—, R⁴S—, (R⁴)₂N—, R⁴OCR⁴ ₂CR⁴ ₂NR⁴—, R⁴OCR⁴ ₂C(═O)NR⁴—, R⁴OCR⁴ ₂CR⁴ ₂O—, R⁴O₂C—, R⁴S, R⁴S(═O)—, R⁴S(═O)₂—, R⁴C(═O)NR⁴—, (R⁴)₂NC(═O)—, (R⁴)₂NC(═O)O—, (R⁴)₂NC(═O)NR⁴—, R⁴OC(═O)NR⁴—, (R⁴)₂NS(═O)₂NR⁴—, R⁴S(═O)₂NR⁴—, R⁴ ₂NS(═O)₂O—, (R⁴O)₂P(═O)O—, R⁴ ₂NCR⁴ ₂C(═O)NR⁴—, N(R⁴)₂C(═NCN)NR⁴—, R⁴S(═O)₂NR⁴C(═O)—, imidazolylamino-, imidazolyl, tetrazolyl, 4-morpholino, azetidinyl, pyrrolidinyl, fluoropyrrolidinyl, oxopiperazinyl, 1, dioxoisothiazolidinyl, methylimidazolyl, methyloxadiazolyl, methylthiadiazolyl and (1-hydroxycyclopropyl)methyl.

Alternatively, R³ is methoxymethyl.

R⁴ is independently selected from H, (C₁-C₆)alkyl and halo(C₁-C₆)alkyl;

or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof. Values for the remaining variables are as defined above for the first or second embodiment of Formula (I).

In a fifth embodiment, the variables in Formula I or any one of Formulas Ia¹⁻¹⁰-Ie¹⁻⁵ are as defined in the following paragraphs:

R¹ is absent or is methyl, ethyl or cyclopropyl.

A¹ is a bond or CH₂ or CH when R¹ is present.

Cy¹ is phenyl, cyclohexyl, pyridyl, N-oxo-pyridyl, thiazolyl or pyrimidinyl each optionally substituted with 1 to 4 groups independently selected from fluorine, chlorine, bromine, iodine, cyano, nitro, amino, hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl, (C₃-C₆)cycloalkyl, (C₃-C₆)cycloalkyl(C₁-C₂)alkyl, hydroxy(C₃-C₆)cycloalkyl, halo(C₁-C₆)alkyl, (C₁-C₆)alkoxy, (C₃-C₆)cycloalkoxy, halo(C₁-C₆)alkoxy, (C₁-C₆)alkanesulfonyl, halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl, H₂NCO, H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl, heterocyclylcarbonyl, (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl, heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino, (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkylsulfonylamino, oxo, cyano(C₁-C₆)alkyl, aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl and di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl.

Cy² is benzimidazolyl, benzotriazolyl and piperidinyl each optionally substituted by 1 to 4 groups independently selected from fluorine, chlorine, bromine, iodine, cyano, nitro, amino, hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl, (C₃-C₆)cycloalkyl, (C₃-C₆)cycloalkyl(C₁-C₂)alkyl, hydroxy(C₃-C₆)cycloalkyl, halo(C₁-C₆)alkyl, (C₁-C₆)alkoxy, (C₃-C₆)cycloalkoxy, halo(C₁-C₆)alkoxy, (C₁-C₆)alkanesulfonyl, halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl, H₂NCO, H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl, (C₁-C₆)cycloalkylcarbonyl, heterocyclylcarbonyl, (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl, heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino, (C₁-C₆)alkylcarbonyl, hydroxy(C₁-C₆)alkylcarbonyl, (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkoxycarbonyl, (C₁-C₆)alkylsulfonylamino, oxo, cyano(C₁-C₆)alkyl, aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl and di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl. Alternatively, when Cy² is piperidinyl, oxo is also a possible substituent.

Alternatively, when R³ is methoxymethyl, Cy² is (a) halogen or —O—SO₃—R, or (b) cycloalkyl, aryl, heterocyclyl, heteroaryl, optionally substituted by 1 to 4 groups independently selected from fluorine, chlorine, bromine, iodine, cyano, nitro, amino, hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl, (C₃-C₆)cycloalkyl, (C₃-C₆)cycloalkyl(C₁-C₂)alkyl, hydroxy(C₃-C₆)cycloalkyl, halo(C₁-C₆)alkyl, (C₁-C₆)alkoxy, (C₃-C₆)cycloalkoxy, halo(C₁-C₆)alkoxy, (C₁-C₆)alkanesulfonyl, halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl, H₂NCO, H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl, heterocyclylcarbonyl, (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl, heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino, (C₁-C₆)alkylcarbonyl, (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkoxycarbonyl, (C₁-C₆)alkylsulfonylamino, oxo, cyano(C₁-C₆)alkyl, aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl and di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl.

R² is methyl, ethyl, propyl, phenyl, thienyl or pyridyl each optionally substituted with halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl, and SO₂Me.

R³ is methyl, ethyl, propyl, butyl, vinyl, allyl or ethoxyethyl each optionally substituted with up to two groups independently selected from methyl, HO—, MeO—, H₂N—, MeC(═O)NH—, MeS(═O)₂NH—, H₂NC(═O)—, MeNHC(═O)—, HO₂C—, (HO)₂P(═O)O—, H₂NS(═O)₂O—, H₂NS(═O)₂NH—, MeNHC(═O)NH—, MeNHC(═O)O—, oxo, cyano, HO₂C—, HOCH₂CH₂NH—, 4-morpholino, HOCH₂C(═O)NH—, H₂NCH₂C(═O)NH—, EtNHC(═O)NH, MeOC(═O)NH—, MeNHC(═NCN)NH—, Me—, MeS—, MeSO₂— MeSO₂N(Me)—, MeS(═O)₂NHC(═O)—, imidazolylamino-, imidazolyl, tetrazolyl, H₂NCONH—, H₂NCO₂—, HOCH₂CH₂O—, MeNH—, Me₂N—, MeCON(Me)—, 2-fluoroethylamino, azetidinyl, pyrrolidinyl, 3-fluoropyrrolidinyl, 3-oxopiperazinyl, 1,1-dioxoisothiazolidin-2-yl, 5-methyl-1H-imidazol-2-yl, 5-methyl-1,3,4-oxadiazol-2-yl, 5-methyl-1,3,4-thiadiazol-2-yl, EtOC(═O)NH—, fluoro or (1-hydroxycyclopropyl)methyl. Alternatively, R³ is methoxymethyl.

R is (i) (C₁-C₄)alkyl optionally substituted with one or more halogen or (ii) phenyl, optionally substituted with halogen, (C₁-C₄)alkyl or NO₂;

Pharmaceutically acceptable salts, enantiomers or diastereomers thereof are also included; and values for the remaining variables are as defined for Formula (I) and for first, second, third or fourth embodiment.

In a sixth embodiment, the variables of Formula I or any one of Formulas Ia¹⁻¹⁰-Ie¹⁻⁵ are as defined in the following paragraphs:

R¹ is absent or is methyl or ethyl.

A¹ is a bond or CH₂ or CH when R¹ is present.

Cy¹ is phenyl, cyclohexyl, pyridyl, N-oxo-pyridyl, thiazolyl or pyrimidinyl each optionally substituted with 1 to 4 groups independently selected from fluorine, chlorine, bromine, iodine, cyano, nitro, amino, hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl, (C₃-C₆)cycloalkyl, (C₃-C₆)cycloalkyl(C₁-C₂)alkyl, hydroxy(C₃-C₆)cycloalkyl, halo(C₁-C₆)alkyl, (C₁-C₆)alkoxy, (C₃-C₆)cycloalkoxy, halo(C₁-C₆)alkoxy, (C₁-C₆)alkanesulfonyl, halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl, H₂NCO, H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl, heterocyclylcarbonyl, (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl, heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino, (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkylsulfonylamino, oxo, cyano(C₁-C₆)alkyl, aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl and di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl.

Cy² is benzimidazolyl, benzotriazolyl and piperidinyl each optionally substituted by 1 to 4 groups independently selected from fluorine, chlorine, bromine, iodine, cyano, nitro, amino, hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl, (C₃-C₆)cycloalkyl, (C₃-C₆)cycloalkyl(C₁-C₂)alkyl, hydroxy(C₃-C₆)cycloalkyl, halo(C₁-C₆)alkyl, (C₁-C₆)alkoxy, (C₃-C₆)cycloalkoxy, halo(C₁-C₆)alkoxy, (C₁-C₆)alkanesulfonyl, halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl, H₂NCO, H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl, heterocyclylcarbonyl, (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl, heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino, (C₁-C₆)alkylcarbonyl, (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkoxycarbonyl, (C₁-C₆)alkylsulfonylamino, oxo, cyano(C₁-C₆)alkyl, aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl and di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl. Alternatively, when Cy² is piperidinyl, oxo is also a possible substituent.

Alternatively, when R³ is methoxymethyl, Cy² is (a) halogen or —O—SO₃—R, or (b) cycloalkyl, aryl, heterocyclyl, heteroaryl, optionally substituted by 1 to 4 groups independently selected from fluorine, chlorine, bromine, iodine, cyano, nitro, amino, hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl, (C₃-C₆)cycloalkyl, (C₃-C₆)cycloalkyl(C₁-C₂)alkyl, hydroxy(C₃-C₆)cycloalkyl, halo(C₁-C₆)alkyl, (C₁-C₆)alkoxy, (C₃-C₆)cycloalkoxy, halo(C₁-C₆)alkoxy, (C₁-C₆)alkanesulfonyl, halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl, H₂NCO, H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl, heterocyclylcarbonyl, (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl, heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino, (C₁-C₆)alkylcarbonyl, (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkoxycarbonyl, (C₁-C₆)alkylsulfonylamino, oxo, cyano(C₁-C₆)alkyl, aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl and di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl.

R² is phenyl, thienyl or pyridyl each optionally substituted with halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl, and SO₂Me.

R³ is methyl, ethyl, propyl, butyl, vinyl, allyl or ethoxyethyl each optionally substituted with up to two groups independently selected from methyl, HO—, MeO—, H₂N—, MeC(═O)NH—, MeS(═O)₂NH—, H₂NC(═O)—, MeNHC(═O)—, HO₂C—, (HO)₂P(═O)O—, H₂NS(═O)₂O—, H₂NS(═O)₂NH—, MeNHC(═O)NH—, MeNHC(═O)O—, oxo, cyano, HO₂C—, HOCH₂CH₂NH—, 4-morpholino, HOCH₂C(═O)NH—, H₂NCH₂C(═O)NH—, EtNHC(═O)NH, MeOC(═O)NH—, MeNHC(═NCN)NH—, Me—, MeS—, MeSO₂— MeSO₂N(Me)—, MeS(═O)₂NHC(═O)—, imidazolylamino-, imidazolyl, tetrazolyl, H₂NCONH—, H₂NCO₂—, HOCH₂CH₂O—, MeNH—, Me₂N—, MeCON(Me)—, 2-fluoroethylamino, azetidinyl, pyrrolidinyl, 3-fluoropyrrolidinyl, 3-oxopiperazinyl, 1,1-dioxoisothiazolidin-2-yl, 5-methyl-1H-imidazol-2-yl, 5-methyl-1,3,4-oxadiazol-2-yl, 5-methyl-1,3,4-thiadiazol-2-yl, EtOC(═O)NH—, fluoro or (1-hydroxycyclopropyl)methyl. Alternatively, R³ is methoxymethyl.

R is (i) (C₁-C₄)alkyl optionally substituted with one or more halogen or (ii) phenyl, optionally substituted with halogen, (C₁-C₄)alkyl or NO₂;

Pharmaceutically acceptable salts, enantiomers or diastereomers thereof are also included; and values for the remaining variables are as defined for first second, third or fourth embodiment.

In a seventh embodiment, the variables in Formula I or any one of Formulas Ia¹⁻¹⁰-Ie¹⁻⁵ are as defined in the following paragraphs:

Cy¹ is phenyl, cyclopropyl, cyclohexyl, pyrrolidinyl, pyridyl, N-oxo-pyridyl, thiazolyl, pyrimidinyl, piperidinyl, each optionally substituted with 1 to 4 groups independently selected from halo, nitro, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl, trifluoromethyl, hydroxy, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, methoxycarbonyl, carboxy, ethoxycarbonylmethoxy, 2-hydroxy-2-methylpropoxy, cyano, difluoromethoxy, t-butoxycarbonyl, hydroxy, hydroxymethyl, 2-hydroxyethyl, 2-hydroxy-2-propyl, methoxymethyl, methylsulfonyl, methylsulfonylamino, trifluoromethoxy and 2,2,2-trifluoroethoxy.

Cy² is benzimidazolyl, benzotriazolyl and piperidinyl each optionally substituted by 1 to 4 groups independently selected from fluorine, chlorine, cyano, hydroxy, amino, (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, (C₁-C₄)alkanesulfonyl, (C₁-C₄)alkyloxycarbonyl, (C₁-C₄)alkylcarbonyl, hydroxy(C₁-C₄)alkylcarbonyl, tetrahydrofuranylcarbonyl, CONH₂, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl, (C₁-C₄)alkylcarbonylamino and (C₁-C₄)haloalkyl. Alternatively, when Cy² is piperidinyl, oxo is also a possible substituent.

Alternatively, when R³ is methoxymethyl, Cy² is (a) halogen or —O—SO₃—R; or (b) cycloalkyl, aryl, heterocyclyl or heteroaryl, optionally substituted by 1 to 4 groups independently selected from fluorine, chlorine, cyano, hydroxy, amino, C₁-C₄ alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, CONH₂, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl and (C₁-C₄)alkylcarbonylamino and C₁-C₄ haloalkyl; and

R is (i) (C₁-C₄)alkyl optionally substituted with one or more halogen or (ii) phenyl, optionally substituted with halogen, (C₁-C₄)alkyl or NO₂;

or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof. Values for the remaining variables are as defined for first second, third, fourth, fifth or sixth embodiment.

In a eighth embodiment, the variables in Formula I or any one of Formulas Ia¹⁻¹⁰-Ie¹⁻⁵ are as defined in the following paragraphs:

Cy¹ is phenyl, cyclopropyl, cyclohexyl, pyrrolidinyl, pyridyl, N-oxo-pyridyl, thiazolyl, pyrimidinyl, piperidinyl, each optionally substituted with 1 to 4 groups independently selected from halo, nitro, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl, trifluoromethyl, hydroxy, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, methoxycarbonyl, carboxy, ethoxycarbonylmethoxy, 2-hydroxy-2-methylpropoxy, cyano, difluoromethoxy, t-butoxycarbonyl, hydroxy, hydroxymethyl, 2-hydroxyethyl, 2-hydroxy-2-propyl, methoxymethyl, methylsulfonyl, methylsulfonylamino, trifluoromethoxy and 2,2,2-trifluoroethoxy.

Cy² is benzimidazolyl, benzotriazolyl and piperidinyl each optionally substituted by 1 to 4 groups independently selected from fluorine, chlorine, cyano, hydroxy, amino, (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, CONH₂, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl, (C₁-C₄)alkylcarbonylamino and (C₁-C₄)haloalkyl. Alternatively, when Cy² is piperidinyl, oxo is also a possible substituent.

Alternatively, when R³ is methoxymethyl, Cy² is (a) halogen or —O—SO₃—R; or (b) cycloalkyl, aryl, heterocyclyl or heteroaryl, optionally substituted by 1 to 4 groups independently selected from fluorine, chlorine, cyano, hydroxy, amino, C₁-C₄ alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, CONH₂, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl and (C₁-C₄)alkylcarbonylamino and C₁-C₄ haloalkyl; and

R is (i) (C₁-C₄)alkyl optionally substituted with one or more halogen or (ii) phenyl, optionally substituted with halogen, (C₁-C₄)alkyl or NO₂;

or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof. Values for the remaining variables are as defined for first second, third, fourth, fifth or sixth embodiment.

In a ninth embodiment, the variables Formula I or any one of Formulas Ia¹⁻¹⁰-Ie¹⁻⁵ are as defined in the following paragraphs:

Cy² is benzimidazolyl, benzotriazolyl and piperidinyl each optionally substituted by 1 to 4 groups independently selected from (C₁-C₆)alkyl, (C₃-C₇)cycloalkyl, (C₃-C₇)cycloalkyl(C₁-C₂)alkyl, (C₁-C₄)alkanesulfonyl, hydroxy(C₁-C₄)alkylcarbonyl, tetrahydrofuranylcarbonyl, CONH₂, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl. Alternatively, when R³ is methoxymethyl, Cy² is (a) halogen or —O—SO₃—R, wherein R is (i) (C₁-C₄)alkyl optionally substituted with one or more halogen or (ii) phenyl, optionally substituted with halogen, (C₁-C₄)alkyl or NO₂; or (b) cycloalkyl, aryl, heterocyclyl or heteroaryl optionally substituted by 1 to 4 groups independently selected from (C₁-C₆)alkyl, (C₃-C₇)cycloalkyl, (C₃-C₇)cycloalkyl(C₁-C₂)alkyl, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl;

or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof, wherein values for the remaining variables are as defined for first second, third, fourth, fifth, sixth seventh or eighth embodiments.

In a tenth embodiment, the variables in Formula I or any one of Formulas Ia¹⁻¹⁰-Ie¹⁻⁵ are as defined in the following paragraphs:

Cy² is benzimidazolyl, benzotriazolyl and piperidinyl each optionally substituted by 1 to 4 groups independently selected from (C₁-C₆)alkyl, (C₃-C₇)cycloalkyl, (C₃-C₇)cycloalkyl(C₁-C₂)alkyl, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl. Alternatively, when R³ is methoxymethyl, Cy² is (a) halogen or —O—SO₃—R, wherein R is (i) (C₁-C₄)alkyl optionally substituted with one or more halogen or (ii) phenyl, optionally substituted with halogen, (C₁-C₄)alkyl or NO₂; or (b) cycloalkyl, aryl, heterocyclyl or heteroaryl optionally substituted by 1 to 4 groups independently selected from (C₁-C₆)alkyl, (C₃-C₇)cycloalkyl, (C₃-C₇)cycloalkyl(C₁-C₂) alkyl, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl;

or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof, wherein values for the remaining variables are as defined for first second, third, fourth, fifth, sixth seventh or eighth embodiments.

Another embodiment of the invention is a compound of any one of Formulas Ia¹⁻¹⁰ or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof; or of any one of Formulas Iba¹⁻¹⁰ or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof:

In Formulas Ia¹⁻¹⁰ and Ib¹⁻¹⁰, the benzimidazolyl, benzotriazolyl and piperidinyl rings are optionally substituted at each substitutable ring nitrogen atom with (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl or (C₁-C₄)haloalkyl and optionally substituted at each substitutable ring carbon atom with fluorine, chlorine, cyano, hydroxy, amino, (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, halo(C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, (C₁-C₄)alkanesulfonyl, hydroxy(C₁-C₄)alkylcarbonyl, tetrahydrofuranylcarbonyl, CONH₂, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl or (C₁-C₄)alkylcarbonylamino Suitable values for the remainder of the variables are as defined in any one of the first, second, third, fourth fifth, sixth, seventh eighth ninth or tenth embodiments.

In another embodiment in Formulas Ia¹⁻¹⁰ and Ib¹⁻¹⁰, the benzimidazolyl, benzotriazolyl and piperidinyl rings are optionally substituted at each substitutable ring nitrogen atom with (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl or (C₁-C₄)haloalkyl and optionally substituted at each substitutable ring carbon atom with fluorine, chlorine, cyano, hydroxy, amino, (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, halo(C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, CONH₂, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl or (C₁-C₄)alkylcarbonylamino Suitable values for the remainder of the variables are as defined in any one of the first, second, third, fourth fifth, sixth, seventh eighth ninth or tenth embodiments.

For each of the embodiments described in the previous two paragraphs, R¹ is preferably methyl or ethyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Ia¹⁻¹⁰ and Ib¹⁻¹⁰, R¹ is preferably methyl or ethyl; and R³ is MeSO₂NHCH₂CH₂CH₂, H₂NC(═O)CH₂CH₂, H₂NC(═O)CMe₂CH₂, 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Ia¹⁻¹⁰ and Formulas Ib¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is isopropyl or phenyl which is optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is MeSO₂NHCH₂CH₂CH₂, H₂NC(═O)CH₂CH₂, H₂NC(═O)CMe₂CH₂, 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Ia¹⁻¹⁰ and Formulas Ib¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is MeSO₂NHCH₂CH₂CH₂, H₂NC(═O)CH₂CH₂, H₂NC(═O)CMe₂CH₂, 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Ia¹⁻¹⁰ and Formulas Ib¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is isopropyl or phenyl which is optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is H₂NC(═O)CMe₂CH₂, 3-hydroxy-3-methylbutyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Ia¹⁻¹⁰ and Formulas Ib¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is H₂NC(═O)CMe₂CH₂, 3-hydroxy-3-methylbutyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Ia¹⁻¹⁰ and Formulas Ib¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is isopropyl or phenyl which is optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, and (C₁-C₄)alkyl; and R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Ia¹⁻¹⁰ and Formulas Ib¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, and (C₁-C₄)alkyl; and R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Ia¹⁻¹⁰ and Formulas Ib¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

For each of the embodiments described in the two paragraphs immediately following Formulas Ia¹⁻¹⁰ and Formulas Ib¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is isopropyl, phenyl or fluorophenyl; and R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

For each of the embodiments described in the two paragraphs immediately following Formulas Ia¹⁻¹⁰ and Formulas Ib¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is phenyl or fluorophenyl; and R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

For each of the embodiments described in the two paragraphs immediately following Formulas Ia¹⁻¹⁰ and Formulas Ib¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is isopropyl, phenyl or fluorophenyl; R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl; substitutable ring nitrogen atoms in the benzimidazolyl and benzotriazolyl rings in Formulas Ib¹⁻¹⁰ are optionally substituted with (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, or (C₁-C₂)haloalkyl; substitutable ring nitrogen atoms in the piperidinyl rings in Formulas Ib¹⁻¹⁰ are optionally substituted with (C₁-C₂)alkanesulfonyl, hydroxy(C₁-C₃)alkylcarbonyl, tetrahydrofuranylcarbonyl, CONH₂, (C₁-C₂)alkylaminocarbonyl, di(C₁-C₂)alkylaminocarbonyl, (C₁-C₂)alkylcarbonyl or (C₁-C₂)allyl; and one or two substitutable ring carbon atoms in the benzimidazolyl, benzotriazolyl and piperidinyl rings in Formulas Ia¹⁻¹⁰ and Ib¹⁻¹⁰ are optionally substituted with methyl or ethyl; and one substitutable ring carbon atoms in piperidinyl rings in Formulas Ia¹⁻¹⁰ and Ib¹⁻¹⁰ is optionally substituted with oxo;

For each of the embodiments described in the two paragraphs immediately following Formulas Ia¹⁻¹⁰ and Formulas Ib¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is phenyl or fluorophenyl; R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl; substitutable ring nitrogen atoms in the benzimidazolyl and benzotriazolyl rings in Formulas Ib¹⁻¹⁰ are optionally substituted with (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, or (C₁-C₂)haloalkyl; and one or two substitutable ring carbon atoms in the benzimidazolyl, benzotriazolyl and piperidinyl rings in Formulas Ia¹⁻¹⁰ and Ib¹⁻¹⁰ are optionally substituted with methyl or ethyl;

For each of the embodiments described in the two paragraphs immediately following Formulas Ia¹⁻¹⁰ and Formulas Ib¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is phenyl or fluorophenyl; R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl; substitutable ring nitrogen atoms in the benzimidazolyl, benzotriazolyl and piperidinyl rings in Formulas Ib¹⁻¹⁰ are optionally substituted with (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, or (C₁-C₂)haloalkyl; and one or two substitutable ring carbon atoms in the benzimidazolyl, benzotriazolyl and piperidinyl rings in Formulas Ia¹⁻¹⁰ and Ib¹⁻¹⁰ are optionally substituted with methyl or ethyl.

Another embodiment of the invention is a compound of any one for Formulas Ic¹⁻¹⁰, or a pharmaceutically acceptable salt thereof:

In Formulas Ic¹⁻¹⁰, the benzimidazolyl, benzotriazolyl and piperidinyl rings are optionally substituted at each substitutable ring nitrogen atom with (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl or (C₁-C₄)haloalkyl and optionally substituted at each substitutable ring carbon atom with fluorine, chlorine, cyano, hydroxy, amino, (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, halo(C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, (C₁-C₄)alkanesulfonyl, hydroxy(C₁-C₄)alkylcarbonyl, tetrahydrofuranylcarbonyl, CONH₂, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl or (C₁-C₄)alkylcarbonylamino. Suitable values for the remainder of the variables are as defined in any one of the first, second, third, fourth, fifth, sixth, seventh eighth ninth or tenth embodiments.

For each of the embodiments described in the previous paragraph, R¹ is preferably methyl or ethyl.

Alternatively, for each of the embodiments described in the paragraph immediately following Formulas Ic¹⁻¹⁰, R¹ is preferably methyl or ethyl; and R³ is MeSO₂NHCH₂CH₂CH₂, H₂NC(═O)CH₂CH₂, H₂NC(═O)CMe₂CH₂, 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the paragraph immediately following Formulas Ic¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is isopropyl or phenyl which is optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is MeSO₂NHCH₂CH₂CH₂, H₂NC(═O)CH₂CH₂, H₂NC(═O)CMe₂CH₂, 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the paragraph immediately following Formulas Ic¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is isopropyl or phenyl which is optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is H₂NC(═O)CMe₂CH₂, 3-hydroxy-3-methylbutyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the paragraph immediately following Formulas Ic¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is isopropyl or phenyl which is optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, and (C₁-C₄)alkyl; and R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

For each of the embodiments described in the paragraph immediately following Formulas Ic¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is isopropyl, phenyl or fluorophenyl; and R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

For each of the embodiments described in the paragraph immediately following Formulas Ic¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is isopropyl, phenyl or fluorophenyl; R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl; substitutable ring nitrogen atoms in the benzimidazolyl and benzotriazolyl rings in Formulas Ic¹⁻¹⁰ are optionally substituted with (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, or (C₁-C₂)haloalkyl; substitutable ring nitrogen atoms in the piperidinyl rings in Formulas Ic¹⁻¹⁰ are optionally substituted with (C₁-C₂)alkanesulfonyl, hydroxy(C₁-C₃)alkylcarbonyl, tetrahydrofuranylcarbonyl, CONH₂, (C₁-C₂)alkylaminocarbonyl, di(C₁-C₂)alkylaminocarbonyl, (C₁-C₂)alkylcarbonyl or (C₁-C₂)alkyl; and one or two substitutable ring carbon atoms in the benzimidazolyl, benzotriazolyl and piperidinyl rings in Formulas Ic¹⁻¹⁰ are optionally substituted with methyl or ethyl; and one substitutable ring carbon atoms in piperidinyl rings in Formulas Ic¹⁻¹⁰ is optionally substituted with oxo; Alternatively in Formulas Ic¹⁻¹⁰, the benzimidazolyl, benzotriazolyl and piperidinyl rings are optionally substituted at each substitutable ring nitrogen atom with (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl or (C₁-C₄)haloalkyl and optionally substituted at each substitutable ring carbon atom with fluorine, chlorine, cyano, hydroxy, amino, (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, halo(C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, CONH₂, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl or (C₁-C₄)alkylcarbonylamino; each G¹ is independently halogen, cyano, oxo, nitro, hydroxy, amino, (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, halo(C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, (C₁-C₄)alkoxycarbonyl, benzoxycarbony, CONH₂, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl, (C₃-C₄)cycloalkylaminocarbonyl, {(C₁-C₄)alkyl}{(C₃-C₄)cycloalkyl}aminocarbonyl and (C₁-C₄)alkylcarbonylamino; r is 0, 1 or 2; and suitable values for the remainder of the variables are as defined in any one of the first, second, third, fourth or fifth, embodiments.

Alternatively, oxo is also a possible substituent for the piperidinyl group in Formulas Ic³, Ic⁸⁻¹⁰.

For each of the embodiments described in the previous paragraph, R¹ is preferably methyl or ethyl.

Alternatively, for each of the embodiments described in the paragraph immediately following Formulas Ic¹⁻¹⁰, R¹ is preferably methyl or ethyl; and R³ is MeSO₂NHCH₂CH₂CH₂, H₂NC(═O)CH₂CH₂, H₂NC(═O)CMe₂CH₂, 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the paragraph immediately following Formulas Ic¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is MeSO₂NHCH₂CH₂CH₂, H₂NC(═O)CH₂CH₂, H₂NC(═O)CMe₂CH₂, 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the paragraph immediately following Formulas Ic¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is H₂NC(═O)CMe₂CH₂, 3-hydroxy-3-methylbutyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the paragraph immediately following Formulas Ic¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the paragraph immediately following Formulas Ic¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is phenyl or fluorophenyl; and R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the paragraph immediately following Formulas Ic¹⁻¹⁰, R¹ is preferably methyl or ethyl; R² is phenyl or fluorophenyl; R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl; substitutable ring nitrogen atoms in the benzimidazolyl, benzotriazolyl and piperidinyl rings in Formulas Ic¹⁻¹⁰ are optionally substituted with (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)allyl, or (C₁-C₂) haloalkyl; and one or two substitutable ring carbon atoms in the benzimidazolyl, benzotriazolyl and piperidinyl rings in Formulas Ic¹⁻¹⁰ are optionally substituted with methyl or ethyl.

Another embodiment of the invention is a compound represented by any one of Formulas Id¹⁻⁷, or a pharmaceutically acceptable salt thereof:

In Formulas Id¹, Id², Id⁶ and Id⁷, G¹ is (C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkyl, (C₁-C₄)haloalkoxy, halogen, cyano or nitro; r is 0, 1 or 2; G^(2a) is (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl or (C₁-C₄)haloalkyl; each G^(2b) is independently hydrogen, fluorine, chlorine, cyano, hydroxy, amino, (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, halo(C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, CONH₂, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl or (C₁-C₄)alkylcarbonylamino; and suitable values for R¹, R² and R³ are as defined in any one of the first, second, third, fourth, fifth, sixth, seventh, eighth, ninth or tenth embodiments, or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof.

In Formulas Id³, Id⁴, and Id⁵, G¹ is (C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkyl, (C₁-C₄)haloalkoxy, halogen, cyano or nitro; r is 0, 1 or 2; G^(2a) is (C₁-C₄)alkyl, (C₁-C₄)alkanesulfonyl, hydroxy(C₁-C₄)alkylcarbonyl, tetrahydrofuranylcarbonyl, CONH₂, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl; each G^(2b) is independently hydrogen, fluorine, chlorine, cyano, hydroxy, amino, (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, halo(C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, CONH₂, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl or (C₁-C₄)alkylcarbonylamino; and suitable values for R¹, R² and R³ are as defined in any one of the first, second, third, fourth, fifth, sixth, seventh, eighth, ninth or tenth embodiments, or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof.

For each of the embodiments described in the previous two paragraphs, R¹ is preferably methyl or ethyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Id¹⁻⁷, R¹ is preferably methyl or ethyl; and R³ is MeSO₂NHCH₂CH₂CH₂, H₂NC(═O)CH₂CH₂, H₂NC(═O)CMe₂CH₂, 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Id¹⁻⁷, R¹ is preferably methyl or ethyl; R² is isopropyl or phenyl which is optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is MeSO₂NHCH₂CH₂CH₂, H₂NC(═O)CH₂CH₂, H₂NC(═O)CMe₂CH₂, 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl. Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Id¹⁻⁷, R¹ is preferably methyl or ethyl; R² is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is MeSO₂NHCH₂CH₂CH₂, H₂NC(═O)CH₂CH₂, H₂NC(═O)CMe₂CH₂, 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Id¹⁻⁷, R¹ is preferably methyl or ethyl; R² is isopropyl or phenyl which is optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is H₂NC(═O)CMe₂CH₂, 3-hydroxy-3-methylbutyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl. Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Id¹⁻⁷, R¹ is preferably methyl or ethyl; R² is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is H₂NC(═O)CMe₂CH₂, 3-hydroxy-3-methylbutyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Id¹⁻⁷, R¹ is preferably methyl or ethyl; R² is isopropyl or phenyl which is optionally substituted with 1, 2 or 3 substituents selected from halo, cyano and (C₁-C₄)alkyl; and R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Id¹⁻⁷, R¹ is preferably methyl or ethyl; R² is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano and (C₁-C₄)alkyl; and R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Id¹⁻⁷, R¹ is preferably methyl or ethyl; R² is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂ and (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me; and R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Id¹⁻⁷, R¹ is preferably methyl or ethyl; R² is isopropyl, phenyl or fluorophenyl; and R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Id¹⁻⁷, R¹ is preferably methyl or ethyl; R² is phenyl or fluorophenyl; and R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl.

Alternatively, for each of the embodiment described in the two paragraphs immediately following Formulas Id¹⁻⁷, R¹ is preferably methyl or ethyl; R² is isopropyl, phenyl or fluorophenyl; R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl; the substituent G^(2a) is selected from (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, and (C₁-C₂)haloalkyl; and each G^(2b) is independently selected from hydrogen, methyl or ethyl.

Alternatively, for each of the embodiment described in the two paragraphs immediately following Formulas Id¹⁻⁷, R¹ is preferably methyl or ethyl; R² is phenyl or fluorophenyl; R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl; the substituent G^(2a) is selected from (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, and (C₁-C₂)haloalkyl; and each G^(2b) is independently selected from hydrogen, methyl or ethyl.

Alternatively, for each of the embodiments described in the two paragraphs immediately following Formulas Id¹⁻⁷, R¹ is preferably methyl or ethyl; R² is isopropyl, phenyl or fluorophenyl; R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl; in Formulas Id¹, Id², Id⁶ and Id⁷, the substituent G^(2a) is selected from selected from hydrogen, methyl or ethyl; and each G^(2b) is independently selected from hydrogen or methyl.

Alternatively, for each of the embodiment described in the two paragraphs immediately following Formulas Id¹⁻⁷, R¹ is preferably methyl or ethyl; R² is isopropyl, phenyl or fluorophenyl; R³ is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl; in Formulas Id³, Id⁴, and Id⁵ the substituent G^(2a) is selected from hydrogen, methyl, methanesulfonyl, acetyl, tetrahydrofuranylcarbonyl, methoxycarbonyl, methylaminocarbonyl and dimethylaminocarbonyl; and each G^(2b) is independently selected from hydrogen or methyl.

Another embodiment of the invention is a compound represented by Formula Ie¹ or a pharmaceutically acceptable salt thereof:

Cy² is (a) halogen or —O—SO₃—R; or (b) cycloalkyl, aryl, heterocyclyl or heteroaryl, optionally substituted with 1 to 4 groups independently selected from fluorine, chlorine, bromine, iodine, cyano, nitro, amino, hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl, (C₃-C₆)cycloalkyl, hydroxy(C₃-C₆)cycloalkyl, (C₃-C₇)cycloalkyl(C₁-C₂)alkyl, (C₂-C₆)alkenyl, halo(C₂-C₆)alkenyl, hydroxy(C₂-C₆)alkenyl, (C₂-C₆)alkynyl, (C₃-C₆)cycloalkyl(C₂-C₄)alkynyl, halo(C₁-C₆)alkyl, halo(C₃-C₆)cycloalkyl, halo(C₃-C₇)cycloalkyl(C₁-C₂)alkyl, (C₁-C₆)alkoxy, (C₃-C₆)cycloalkoxy, (C₃-C₇)cycloalkyl(C₁-C₂)alkoxy, halo(C₁-C₆)alkoxy, halo(C₃-C₆)cycloalkoxy, halo(C₃-C₇)cycloalkyl(C₁-C₂)alkoxy, (C₁-C₆)alkylthio, (C₃-C₆)cycloalkythio, (C₃-C₇)cycloalkyl(C₁-C₂)alkylthio, halo(C₁-C₆)alkylthio, halo(C₃-C₆)cycloalkythio, halo(C₃-C₇)cycloalkyl(C₁-C₂)alkylthio, (C₁-C₆)alkanesulfinyl, (C₃-C₆)cycloalkanesulfinyl, (C₃-C₇)cycloalkyl(C₁-C₂)alkanesulfinyl, halo(C₁-C₆)alkanesulfinyl, halo(C₃-C₆)cycloalkanesulfinyl, halo(C₃-C₇)cycloalkyl(C₁-C₂)alkanesulfinyl, (C₁-C₆)alkanesulfonyl, (C₃-C₆)cycloalkanesulfonyl, (C₃-C₇)cycloalkyl(C₁-C₂)alkanesulfonyl, halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl, halo(C₃-C₇)cycloalkyl(C₁-C₂)alkanesulfonyl, (C₁-C₆)alkylamino, di(C₁-C₆)alkylamino, (C₁-C₆)alkoxy(C₁-C₆)alkoxy, halo(C₁-C₆)alkoxy(C₁-C₆)alkoxy, (C₁-C₆)alkoxycarbonyl, H₂NCO, H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl, (C₁-C₃)alkoxy(C₁-C₃)alkylaminocarbonyl, heterocyclylcarbonyl, (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl, heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino, (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkylsulfonylamino, (C₁-C₆)alkylsulfonylamino(C₁-C₆)alkyl, (C₁-C₆)alkoxycarbonyl(C₁-C₆)alkoxy, (C₁-C₆)alkoxy(C₁-C₆)alkyl, halo(C₁-C₆)alkoxy(C₁-C₆)alkyl, hydroxy(C₁-C₆)alkoxy, heteroaryl, amino(C₁-C₆)alkyl, (C₁-C₆)alkylamino(C₁-C₆)alkyl, di(C₁-C₆)alkylamino(C₁-C₆)alkylamino(C₂-C₆)alkoxy, (C₁-C₆)alkylamino(C₂-C₆)alkoxy, di(C₁-C₆)alkylamino(C₂-C₆)alkoxy, (C₁-C₆)alkylcarbonyl, (C₃-C₆)cycloalkylcarbonyl, (C₃-C₆)cycloalkylaminocarbonyl, {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl, di(C₃-C₆)cycloalkylaminocarbonyl, (C₃-C₆)cycloalkylaminosulfonyl, {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminosulfonyl, di(C₃-C₆)cycloalkylaminosulfonyl, cyano(C₁-C₆)alkyl, aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl, di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl, (C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl, {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl(C₁-C₆)alkyl and di(C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl; R is (i) (C₁-C₄)alkyl optionally substituted with one or more halogen or (ii) phenyl, optionally substituted with halogen, (C₁-C₄)alkyl or NO₂; the phenyl ring is optionally substituted with (C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkyl, (C₁-C₄) haloalkoxy, halogen, cyano and nitro; and suitable values for the remainder of the variables are as defined in any one of the first, second, third, fourth or fifth embodiments.

For each of the embodiments described in the previous paragraph, R¹ is preferably methyl or ethyl.

Another embodiment of the invention is a compound represented by any one of Formulas Ie²⁻⁵, or a pharmaceutically acceptable salt thereof:

r is 0, 1, 2 or 3; each G¹ is independently (C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkyl, (C₁-C₄)haloalkoxy, halogen, cyano and nitro; suitable substituents for the group represented by Cy² are as described for Formula Ie¹ and suitable values for the remainder of the variables are as defined for the variables in Formula Ie¹.

For each of the embodiments described in the paragraph immediately following Formulas Ie¹⁻⁵, Cy² is preferably phenyl, thienyl, pyridyl, piperidinyl, piperazinyl, morpholinyl, thiazolyl, oxadiazolyl, thiadiazolyl, pyrazolyl, 1,2,3-triazolyl, 1,2,4-triazolyl, tetrazolyl, pyridazinyl, pyrimidinyl, pyrazinyl, benzimidazolyl, benztriazolyl, oxodihydropyridyl, oxodihydropyridazinyl, oxodihydropyrimidinyl and oxodihydropyrazinyl, each optionally substituted by 1 to 4 groups, wherein suitable substituents for a substitutable ring nitrogen atom are selected from (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, (C₁-C₄)halo alkyl, (C₁-C₄)alkoxycarbonyl, (C₁-C₄)alkylcarbonyl and benzyloxycarbonyl; and suitable substituents for a ring carbon atom in the are selected from fluorine, chlorine, cyano, hydroxy, amino, (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, halo(C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, CONH₂, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl and (C₁-C₄)alkylcarbonylamino.

Alternatively, for each of the embodiments described in the paragraph immediately following Formulas Ie¹⁻⁵, preferably Cy² is as described in the previous paragraph, and R² is phenyl, thienyl, or pyridyl, each optionally substituted with halogen, nitro, cyano, (C₁-C₆)alkyl, halo(C₁-C₆)alkyl, hydroxy(C₁-C₃)alkyl, (C₁-C₃)alkoxy, halo(C₁-C₃)alkoxy, CONH₂ and SO₂Me.

For each of the embodiments described in the paragraph immediately following Formulas Ie¹⁻⁵, preferably Cy² is as described in the previous paragraph, R² is phenyl, thienyl, or pyridyl, each optionally substituted with halogen, nitro, cyano, (C₁-C₆)alkyl, halo(C₁-C₆)alkyl, hydroxy(C₁-C₃)alkyl, (C₁-C₃)alkoxy, halo(C₁-C₃)alkoxy, CONH₂ and SO₂Me, and R¹ is methyl or ethyl. More preferably, R² is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH₂, (C₁-C₄)alkyl, (C₁-C₄)haloalkyl and SO₂Me.

For the embodiments described in the previous paragraph, R² is more preferably phenyl or fluorophenyl.

The present invention further provides methods of inhibiting 1113-HSD1 by contacting 11β-HSD1 with a compound of Formula I, Ia¹⁻¹⁰, Ib¹⁻¹⁰, Ic¹⁻¹⁰, Id¹⁻⁷, Ie¹⁻⁵ of the invention.

The present invention further provides methods of inhibiting or reducing the conversion of cortisone to cortisol in a cell using a compound of Formula I, Ia¹⁻¹⁰, Ib¹⁻¹⁰, Ic¹⁻¹⁰, Id¹⁻⁷ or Ie¹⁻⁵ of the invention.

The present invention further provides methods of inhibiting or reducing production of cortisol in a cell using a compound of Formula I, Ia¹⁻¹⁰, Ib¹⁻¹⁰, Ic¹⁻¹⁰, Id¹⁻⁷ or Ie¹⁻⁵ of the invention.

The present invention further provides methods of increasing insulin sensitivity in a subject in need thereof using a compound of Formula I, Ia¹⁻¹⁰, Ib¹⁻¹⁰, Ic¹⁻¹⁰, Id¹⁻⁷ or Ie¹⁻⁵ of the invention.

The present invention further provides methods of treating a subject with a disease associated with activity of expression of 11β-HSD1 using a compound of Formula I, Ia¹⁻¹⁰, Ib¹⁻¹⁰, Ic¹⁻¹⁰, Id¹⁻⁷ or Ie¹⁻⁵ of the invention.

Preferred values for the variables in the above-described structural formulas I, Ia¹⁻¹⁰, Ib¹⁻¹⁰, Ic¹⁻¹⁰, Id¹⁻⁷ or Ie¹⁻⁵ are provided below:

DEFINITIONS

The term “alkyl” means a straight or branched hydrocarbon radical having 1-10 carbon atoms and includes, for example, methyl, ethyl, n-propyl, isopropyl, n-butyl, sec-butyl, isobutyl, tert-butyl, n-pentyl, n-hexyl, n-heptyl, n-octyl, n-nonyl, n-decyl and the like.

The term “cycloalkyl” means a monocyclic, bicyclic or tricyclic, saturated hydrocarbon ring having 3-10 carbon atoms and includes, for example, cyclopropyl (c-Pr), cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, cyclooctyl, bicyclo[2.2.2]octyl, bicyclo[2.2.1]heptyl, spiro[4.4]nonane, adamantyl and the like.

The term “aryl” means an aromatic radical which is a phenyl group, a naphthyl group, an indanyl group or a tetrahydronaphthalene group. When substituted, an aryl group has 1-4 substituents. Exemplary substituents include alkyl, alkoxy, alkylthio, alkylsulfonyl, halogen, trifluoromethyl, dialkylamino, nitro, cyano, CO₂H, CONH₂, N-monoalkyl-substituted amido and N,N-dialkyl-substituted amido.

The term “heteroaryl” means a 5- and 6-membered heteroaromatic radical which may optionally be fused to a saturated or unsaturated ring containing 0-4 heteroatoms selected from N, O, and S and includes, for example, a heteroaromatic radical which is 2- or 3-thienyl, 2- or 3-furanyl, 2- or 3-pyrrolyl, 2-, 3-, or 4-pyridyl, 2-pyrazinyl, 2-, 4-, or 5-pyrimidinyl, 3- or 4-pyridazinyl, 1H-indol-6-yl, 1H-indol-5-yl, 1H-benzimidazol-6-yl, 1H-benzimidazol-5-yl, 2-, 4-, 5-, 6-, 7- or 8-quinazolinyl, 2-, 3-, 5-, 6-, 7- or 8-quinoxalinyl, 2-, 3-, 4-, 5-, 6-, 7- or 8-quinolinyl, 1-, 3-, 4-, 5-, 6-, 7- or 8-isoquinolinyl, 2-, 4-, or 5-thiazolyl, 2-, 3-, 4-, or 5-pyrazolyl, 2-, 3-, 4-, or 5-imidazolyl. Exemplary substituents for a substituted heteroaryl include alkyl, alkoxy, alkylthio, alkylsulfonyl, halogen, trifluoromethyl, dialkylamino, nitro, cyano, CO₂H, CONH₂, N-monoalkyl-substituted amido and N,N-dialkyl-substituted amido, or by oxo to form an N-oxide.

The term “heterocyclyl” means a 4-, 5-, 6- and 7-membered saturated or partially unsaturated heterocyclic ring containing 1 to 4 heteroatoms independently selected from N, O, and S. Exemplary heterocyclyls include pyrrolidine, 1-methylpyrrolidine, pyrrolidin-2-one, 1-methylpyrrolidin-2-one, piperidine, piperidin-2-one, dihydropyridine, tetrahydropyridine, piperazine, 1-(2,2,2-trifluoroethyl)piperazine, 1,2-dihydro-2-oxopyridine, 1,4-dihydro-4-oxopyridine, piperazin-2-one, 3,4,5,6-tetrahydro-4-oxopyrimidine, 3,4-dihydro-4-oxopyrimidine, tetrahydrofuran, tetrahydropyran, tetrahydrothiophene, tetrahydrothiopyran, isoxazolidine, 1,3-dioxolane, 1,3-dithiolane, 1,3-dioxane, 1,4-dioxane, 1,3-dithiane, 1,4-dithiane, oxazolidin-2-one, imidazolidin-2-one, imidazolidine-2,4-dione, tetrahydropyrimidin-2(1H)-one, morpholine, N-methylmorpholine, morpholin-3-one, 1,3-oxazinan-2-one, thiomorpholine, thiomorpholine 1,1-dioxide, tetrahydro-1,2,5-thiaoxazole 1,1-dioxide, tetrahydro-2H-1,2-thiazine 1,1-dioxide, hexahydro-1,2,6-thiadiazine 1,1-dioxide, tetrahydro-1,2,5-thiadiazole 1,1-dioxide isothiazolidine 1,1-dioxide, 6-oxo-1,6-dihydropyridazin-3-yl, 6-oxo-1,6-dihydropyridazin-4-yl, 5-oxo-4,5-dihydro-1H-1,2,4-triazol-3-yl and 5-oxo-4,5-dihydro-1H-imidazol-2-yl. When substituted, a heterocyclyl has 1-4 substituents. Exemplary substituents include alkyl, haloalkyl, halogen and oxo.

“Substitutable ring nitrogen atom” refers to a ring nitrogen atom in a heteroaryl or heterocyclyl group that is bonded to a hydrogen atom. The hydrogen atom can be replaced, i.e., substituted, with a substituent. A “substitutable ring carbon atom” refers to a carbon atom in an aryl or cycloalkyl that is bonded to a hydrogen atom. The hydrogen atom can be replaced, i.s., substituted, with a substituent.

The term “spirocycloalkyl” means a cycloalkyl group which shares one ring carbon with another alkyl or cycloalkyl group.

As used herein the terms “subject” and “patient” may be used interchangeably, and means a mammal in need of treatment, e.g., companion animals (e.g., dogs, cats, and the like), farm animals (e.g., cows, pigs, horses, sheep, goats and the like) and laboratory animals (e.g., rats, mice, guinea pigs and the like). Typically, the subject is a human in need of treatment.

When a disclosed compound or its pharmaceutically acceptable salt is named or depicted by structure, it is to be understood that solvates or hydrates of the compound or its pharmaceutically acceptable salts are also included. “Solvates” refer to crystalline forms wherein solvent molecules are incorporated into the crystal lattice during crystallization. Solvate may include water or nonaqueous solvents such as ethanol, isopropanol, DMSO, acetic acid, ethanolamine, and EtOAc. Solvates, wherein water is the solvent molecule incorporated into the crystal lattice, are typically referred to as “hydrates.” Hydrates include stoichiometric hydrates as well as compositions containing variable amounts of water.

Certain of the disclosed compounds may exist in various stereoisomeric forms. Stereoisomers are compounds that differ only in their spatial arrangement. Enantiomers are pairs of stereoisomers whose mirror images are not superimposable, most commonly because they contain an asymmetrically substituted carbon atom that acts as a chiral center. “Enantiomer” means one of a pair of molecules that are mirror images of each other and are not superimposable. Diastereomers are stereoisomers that are not related as mirror images, most commonly because they contain two or more asymmetrically substituted carbon atoms. The symbol “*” in a structural formula represents the presence of a chiral carbon center. “R” and “S” represent the configuration of substituents around one or more chiral carbon atoms. Thus, “R*” and “S*” denote the relative configurations of substituents around one or more chiral carbon atoms.

“Racemate” or “racemic mixture” means a compound of equimolar quantities of two enantiomers, wherein such mixtures exhibit no optical activity; i.e., they do not rotate the plane of polarized light.

“Geometric isomer” means isomers that differ in the orientation of substituent atoms in relationship to a carbon-carbon double bond, to a cycloalkyl ring, or to a bridged bicyclic system. Atoms (other than H) on each side of a carbon-carbon double bond may be in an E (substituents are on opposite sides of the carbon-carbon double bond) or Z (substituents are oriented on the same side) configuration.

“R,” “S,” “S*,” “R*,” “E,” “Z,” “cis,” and “trans,” indicate configurations relative to the core molecule.

Tautomeric forms exist when a compound is a mixture of two or more structurally distinct compounds that are in rapid equilibrium. Certain compounds of the invention exist as tautomeric forms. For example, the following compound represented by Structural Formula (A) and (B) include at least the following tautomers forms:

It is to be understood that when one tautormeric form of a compound is depicted by name or structure, all tautomeric forms of the compound are included.

The compounds of the invention may be prepared as individual isomers by either isomer-specific synthesis or resolved from an isomeric mixture. Conventional resolution techniques include forming the salt of a free base of each isomer of an isomeric pair using an optically active acid (followed by fractional crystallization and regeneration of the free base), forming the salt of the acid form of each isomer of an isomeric pair using an optically active amine (followed by fractional crystallization and regeneration of the free acid), forming an ester or amide of each of the isomers of an isomeric pair using an optically pure acid, amine or alcohol (followed by chromatographic separation and removal of the chiral auxiliary), or resolving an isomeric mixture of either a starting material or a final product using various well known chromatographic methods.

When the stereochemistry of a disclosed compound is named or depicted by structure, the named or depicted stereoisomer is at least 60%, 70%, 80%, 90%, 99% or 99.9% by weight pure relative to the other stereoisomers. When a single enantiomer is named or depicted by structure, the depicted or named enantiomer is at least 60%, 70%, 80%, 90%, 99% or 99.9% by weight optically pure. Percent optical purity by weight is the ratio of the weight of the enantiomer over the weight of the enantiomer plus the weight of its optical isomer.

When a disclosed compound is named or depicted by structure without indicating the stereochemistry, and the compound has at least one chiral center, it is to be understood that the name or structure encompasses one enantiomer of compound free from the corresponding optical isomer, a racemic mixture of the compound and mixtures enriched in one enantiomer relative to its corresponding optical isomer.

When a disclosed compound is named or depicted by structure without indicating the stereochemistry and has at least two chiral centers, it is to be understood that the name or structure encompasses a diastereomer free of other diastereomers, a pair of diastereomers free from other diastereomeric pairs, mixtures of diastereomers, mixtures of diastereomeric pairs, mixtures of diastereomers in which one diastereomer is enriched relative to the other diastereomer(s) and mixtures of diastereomeric pairs in which one diastereomeric pair is enriched relative to the other diastereomeric pair(s).

The compounds of the invention may be present in the form of pharmaceutically acceptable salts. For use in medicines, the salts of the compounds of the invention refer to non-toxic “pharmaceutically acceptable salts.” Pharmaceutically acceptable salt forms include pharmaceutically acceptable acidic/anionic or basic/cationic salts.

Pharmaceutically acceptable basic/cationic salts include, the sodium, potassium, calcium, magnesium, diethanolamine, n-methyl-D-glucamine, L-lysine, L-arginine, ammonium, ethanolamine, piperazine and triethanolamine salts.

Pharmaceutically acceptable acidic/anionic salts include, the acetate, benzenesulfonate, benzoate, bicarbonate, bitartrate, bromide, calcium edetate, camsylate, carbonate, chloride, citrate, dihydrochloride, edetate, edisylate, estolate, esylate, fumarate, glyceptate, gluconate, glutamate, glycollylarsanilate, hexylresorcinate, hydrobromide, hydrochloride, hydroxynaphthoate, iodide, isethionate, lactate, lactobionate, malate, maleate, malonate, mandelate, mesylate, methylsulfate, mucate, napsylate, nitrate, pamoate, pantothenate, phosphate/diphospate, polygalacturonate, salicylate, stearate, subacetate, succinate, sulfate, hydrogensulfate, tannate, tartrate, teoclate, tosylate, and triethiodide salts.

The following abbreviations have the indicated meanings:

Abbreviation Meaning A % Area percentage Boc tert-butoxy carbonyl or t-butoxy carbonyl (Boc)₂O di-tert-butyl dicarbonate Cbz Benzyloxycarbonyl CbzCl Benzyl chloroformate c-Pr cyclopropyl DAST diethylaminosulfur trifluoride DBU 1,8-diazabicyclo[5.4.0]undec-7-ene DCC N,N′-dicyclohexylcarbodiimide DCU N,N′-dicyclohexylurea DIAD diisopropyl azodicarboxylate DIBAL-H diisobutylaluminum hydride DIEA N,N-diisopropylethylamine DMAP 4-(dimethylamino)pyridine DMF N,N-dimethylformamide DMPU 1,3-dimethyl-3,4,5,6-tetrahydro-2(1H)-pyrimidinone 2,4-DNP 2,4-dinitrophenylhydrazine DPTBS Diphenyl-t-butylsilyl dr diastereomer ratio EDC•HCl, EDCI 1-[3-(dimethylamino)propyl]-3-ethylcarbodiimide hydrochloride Equiv equivalents EtOAc ethyl acetate Fmoc 1-[[(9H-fluoren-9-ylmethoxy)carbonyl]oxy]- Fmoc—OSu 1-[[(9H-fluoren-9-ylmethoxy)carbonyl]oxy]- 2,5-pyrrolidinedione h, hr hour(s) HOBt 1-hydroxybenzotriazole HATU 2-(7-Aza-1H-benzotriazole-1-yl)-1,1,3,3- tetramethyluronium hexafluorophosphate HBTU 2-(1H-Benzotriazol-1-yl)-1,1,3,3-tetramethyluronium hexafluorophosphate KHMDS potassium hexamethyldisilazane LAH or LiAlH₄ lithium aluminum hydride LC-MS liquid chromatography-mass spectroscopy LHMDS lithium hexamethyldisilazane m-CPBA meta-chloroperoxybenzoic acid Me methyl MsCl methanesulfonyl chloride Min minute MS mass spectrum NaH sodium hydride NaHCO₃ sodium bicarbonate NaN₃ sodium azide NaOH sodium hydroxide Na₂SO₄ sodium sulfate NMM N-methylmorpholine NMP N-methylpyrrolidinone Pd₂(dba)₃ tris(dibenzylideneacetone)dipalladium(0) PE petroleum ether Quant quantitative yield rt room temperature Satd saturated SOCl₂ thionyl chloride SFC supercritical fluid chromatography SPA scintillation proximity assay SPE solid phase extraction TBAF tetrabutylammonium fluoride TBS t-butyldimethylsilyl TBDPS t-butyldiphenylsilyl TBSCl t-butyldimethylsilyl chloride TBDPSCl t-butyldiphenylsilyl chloride TEA triethylamine or Et₃N TEMPO 2,2,6,6-tetramethyl-1-piperidinyloxy free radical Teoc 1-[2-(trimethylsilyl)ethoxycarbonyloxy]- Teoc-OSu 1-[2-(trimethylsilyl)ethoxycarbonyloxy]pyrrolidin- 2,5-dione T_(ext) External temperature T_(int) Internal temperature TFA trifluoroacetic acid Tlc, TLC thin layer chromatography TMS trimethylsilyl TMSCl chlorotrimethylsilane or trimethylsilyl chloride t_(R) retention time TsOH p-toluenesulfonic acid General Description of Synthetic Methods

Compounds of Formula I can be prepared by several processes. In the discussion below, A¹, Cy¹, Cy², E, R¹, R², R³, Y and n have the meanings indicated above unless otherwise noted. In cases where the synthetic intermediates and final products of Formulas I described below contain potentially reactive functional groups, for example amino, hydroxyl, thiol and carboxylic acid groups, that may interfere with the desired reaction, it may be advantageous to employ protected forms of the intermediate. Methods for the selection, introduction and subsequent removal of protecting groups are well known to those skilled in the art (see e.g. T. W. Greene and P. G. M. Wuts “Protective Groups in Organic Synthesis” John Wiley & Sons, Inc., New York 1999). Such protecting group manipulations are assumed in the discussion below and not described explicitly. Generally, reagents in the reaction schemes are used in equimolar amounts; however, in certain cases it may be beneficial to use an excess of one reagent to drive a reaction to completion. This is especially the case when the excess reagent can be readily removed by evaporation or extraction. Bases employed to neutralize HCl in reaction mixtures are generally used in slight to substantial excess (1.05-5 equivalents).

Compounds of Formula I can be prepared by reaction of a ketocarbamate of Formula II, wherein R^(D) is alkyl or arylalkyl such as methyl, t-butyl or benzyl, with an organometallic reagent of Formula III wherein M includes, but is not limited to, MgCl, MgBr, MgI or Li:

In specific examples, organometallic reagent III is allylmagnesium bromide, allylzinc bromide, (2-methylallyl)magnesium chloride or (2-methoxy-2-oxoethyl)zinc bromide. In certain cases when M is MgCl, MgBr or MgI, it is advantageous to add CeCl₃ to the reaction mixture.

Ketocarbamates of Formula II can be prepared by reaction of aminoketones of Formula IV with intermediates of Formula V wherein R^(E) is a leaving group such as chlorine, succinyloxy, imidazolyl or t-butoxycarboxycarbonyl:

Aminoketones of Formula IV, wherein n is preferably but not necessarily 0, can be prepared by reaction of α,β-unsaturated ketones of Formula V with amines of Formula VII:

Alternatively, aminoketones of Formula IV, wherein n is preferably but not necessarily 0, can be prepared by reaction of β-dialkylaminoketones of Formula VI, wherein R^(F) is lower alkyl especially methyl, with amines of Formula VII:

β-Dialkylaminoketones of Formula VI are in turn derived from α,β-unsaturated ketones of Formula V with dialkylamines of Formula R^(F)NHR^(F).

Compounds of Formula Ie¹ can be prepared according to the following scheme:

A methoxymethyl ketone of Formula VIII is reacted with an organometallic allyl reagent of Formula IX wherein M includes, but is not limited to, MgCl, MgBr, MgI or Li to yield an allyl compound of Formula X. In specific examples, organometallic reagent IX is allylmagnesium chloride, allylmagnesium bromide or allylzinc(II) bromide. The reaction is optionally carried out in the presence of anhydrous cerium trichloride

Allyl compound of Formula X is converted to the aldehyde of Formula XII by ozonolysis or by OsO₄ catalysed dihydroxylation followed by cleavage of the glycol of Formula XI by periodates like sodium periodate Aminocarbinol of Formula XIV can be prepared by reductive amination with an amine of Formula XIII using sodium cyanoborohydride or sodium triacetoxyborohydride as reducing agent. Cyclisation of the aminocarbinol of Formula XIV to the compounds of Formula Ie¹ can be achieved by reacting with activated carbonic acid derivates such as phosgene, diphosgene, triphosgene or 1,1′-carbonyl-diimidazol.

Alternatively compounds of Formula (I) can be prepared from the reaction product of compounds represented by formulas II and III wherein Cy¹ is phenyl substituted with a leaving group such as bromine, for example, by using a “Suzuki” coupling reaction with Cy²-X[X is —B(OH)₂] as described in Example 111 of U.S. Provisional Patent Application No. 60/962,058, filed Jul. 26, 2007. The entire teachings of this application are incorporated herein by reference.

A compound of Formula I can also be prepared by reaction of a halo compound, wherein Hal is chlorine or bromine, with an isocyanate in the presence of a base:

Halo compounds of this type can be prepared by reaction of β-haloketones with organometallic reagents R³-M, wherein M is a metal containing residue including MgCl, MgBr, MgI or Li. The reaction is optionally carried out in the presence of anhydrous cerium trichloride:

Specific conditions for these reactions are described in SYNTHESIS OF INHIBITORS OF 11BETA-HYDROXYSTEROID DEHYDROGENASE TYPE 1 (11β-HSD1), filed Jul. 25, 2008 as U.S. Provisional Application No. 61/137,013, the entire teachings of which are incorporated herein by reference.

LC-MS METHODS LC-MS method 1: Column Merck Cromolith Speed ROD, RP18e, 50 × 4.6 mm Mobile Phase A: water + 0.1% HCO₂H B: acetonitrile + 0.1% HCO₂H TIME (min) A % B % 0 90 10 4.50 10 90 5.00 10 90 5.50 90 10 Flow Rate 1.5 mL/min Wavelength UV 220, 230, or 254 nm LC-MS method 2: Column Waters Xbridge C18, 30 × 4.6 mm, 2.5 μm Mobile Phase A: water + 0.1% NH₃ B: methanol TIME (min) A % B % 0 90 10 0.15 90 10 4.00 0 100 4.40 0 100 4.55 90 10 5.00 90 10 Flow Rate 1.6 mL/min Wavelength UV 220, 230, or 254 nm

Intermediate I 3-[(S)-1-(4-Chloro-phenyl)-ethylamino]-1-phenyl-propan-1-one

NEt₃ (60 mL) followed by (S)-1-(4-chloro-phenyl)-ethylamine (20.5 g) was added to a solution of 3-chloro-1-phenyl-propan-1-one (23.2 g) in tetrahydrofuran (200 mL). The resulting mixture was stirred at room temperature overnight. Then, the solution was concentrated, water (100 mL) was added to the residue, and the resulting mixture was extracted with tert-butyl methyl ether. The combined organic extracts were washed with water and brine and dried (MgSO₄). The title compound was obtained after removal of the solvent.

Yield: 38.0 g (quantitative); Mass spectrum (EST⁺): m/z=288/290 (Cl) [M+H]⁺

The following compound was obtained in analogy to Intermediate I:

(1) 3-[(S)-1-(4-Bromo-phenyl)-ethylamino]-1-phenyl-propan-1-one

Mass spectrum (EST⁺): m/z=332/334 (Br) [M+H]⁺

Intermediate II [(S)-1-(4-Chloro-phenyl)-ethyl]-(3-oxo-3-phenyl-propyl)-carbamic acid methyl ester

Methyl chloroformate (15.5 mL) dissolved in dichloromethane (100 mL) was added to a mixture of 3-[(S)-1-(4-chloro-phenyl)-ethylamino]-1-phenyl-propan-1-one (38.0 g) and Na₂CO₃ (23.5 g) in a mixture of dichloromethane (100 mL) and water (100 mL) at such a rate that the solution temperature remained between 20 and 26° C. After complete addition, the solution was stirred at ambient temperature for an additional 30 min. Then, the organic phase was separated and the aqueous phase was extracted once with dichloromethane. The combined organic phases were washed with brine and dried (MgSO₄). Then, silica gel (20 g) was added and the resulting mixture was stirred vigorously for 30 min. The silica gel was separated by filtration, washed with dichloromethane (200 mL), and the combined filtrate was concentrated under reduced pressure to give an oil. The oil was treated with iPr₂O (150 mL) to precipitate the title compound that was separated by filtration, washed with petroleum ether (30 mL), and dried. The filtrate was concentrated and the residue was taken up in petroleum ether (60 mL). The precipitate formed after a while of stirring was separated by filtration, washed with petroleum ether (20 mL), dried, and combined with the precipitate obtained before.

Yield: 38.2 g (82% of theory); Mass spectrum (ESI⁺): m/z=346/348 (Cl) [M+H]⁺.

The following compound was obtained in analogy to Intermediate II:

(1) [(S)-1-(4-Bromo-phenyl)-ethyl]-(3-oxo-3-phenyl-propyl)-carbamic acid methyl ester

Mass spectrum (ESI⁺): m/z=390/392 (Br) [M+H]⁺

Intermediate III 5-{[(S)-1-(4-Chloro-phenyl)-ethyl]-methoxycarbonyl-amino}-3-hydroxy-3-phenyl-pentanoic acid methyl ester (mixture of two diastereomers)

Et₂Zn (1 M in hexane, 55 mL) was added dropwise to [(S)-1-(4-chloro-phenyl)-ethyl]-(3-oxo-3-phenyl-propyl)-carbamic acid methyl ester (3.80 g) dissolved in 1,2-dichloroethane (30 mL) and chilled to 0° C. under argon atmosphere. Then, (Ph₃P)₃RhCl (0.50 g) was added followed by the dropwise addition of methyl bromoacetate (1.0 mL) dissolved in 1,2-dichloroethane (10 mL). The resulting solution was stirred at 0-5° C. for 1 h and at ambient temperature for another 1.5 h. The solution was poured into ice-cold half-saturated aqueous NH₄Cl solution (150 mL). After addition of dichloromethane, the mixture was filtered through Celite which was extracted with an additional portion of dichloromethane. The organic phase was separated and washed with water and dried (MgSO₄). The solvent was removed and the residue was purified by chromatography on silica gel (cyclohexane/ethyl acetate 85:15→70:30) to give the title compound as a mixture of two diastereomers.

Yield: 4.6 g (quantitative); Mass spectrum (ESI⁺): m/z=420/422 (Cl) [M+H]⁺.

The following compound was obtained in analogy to Intermediate III:

(1) 5-{[(S)-1-(4-Bromo-phenyl)-ethyl]-methoxycarbonyl-amino}-3-hydroxy-3-phenyl-pentanoic acid methyl ester (mixture of two diastereomers)

Mass spectrum (ESI⁺): m/z=464/466 (Br) [M+H]⁺

Intermediate IV [(S)-1-(4-Chloro-phenyl)-ethyl]-(3,5-dihydroxy-5-methyl-3-phenyl-hexyl)-carbamic acid methyl ester (mixture of two diastereomers)

MeLi (1.6 M in Et₂O, 5.1 mL) diluted with tetrahydrofuran (3 mL) was added to a solution of 5-{[(S)-1-(4-chloro-phenyl)-ethyl]-methoxycarbonyl-amino}-3-hydroxy-3-phenyl-pentanoic acid methyl ester (product from Intermediate III, 1.10 g) in tetrahydrofuran (8 mL) chilled to −75° C. under argon atmosphere. The solution was stirred at ca. −70° C. for 2.5 h and then poured into half-saturated aqueous NH₄Cl solution (150 mL). The resulting mixture was extracted with ethyl acetate and the combined extracts were washed with brine and dried (MgSO₄). The solvent was removed and the residue was purified by chromatography on silica gel (cyclohexane/ethyl acetate 85:15→70:30) to give the title compound as a mixture of two diastereomers.

Yield: 0.62 g (56% of theory); Mass spectrum (ESI⁺): m/z=420/422 (Cl) [M+H]⁺. The reaction may also be conducted using MeMgCl instead of MeLi as described above.

The following compound was obtained in analogy to Intermediate IV:

(1) [(S)-1-(4-Bromo-phenyl)-ethyl]-(3,5-dihydroxy-5-methyl-3-phenyl-hexyl)-carbamic acid methyl ester (mixture of two diastereomers)

Mass spectrum (ESI⁺): m/z=464/466 (Br) [M+H]⁺.

Intermediate V 3-[(S)-1-(4-Chloro-phenyl)-ethyl]-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one and 3-[(S)-1-(4-chloro-phenyl)-ethyl]-(R)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

NaH (60% in mineral oil, 0.15 g) was added to a solution of [(S)-1-(4-chloro-phenyl)-ethyl]-(3,5-dihydroxy-5-methyl-3-phenyl-hexyl)-carbamic acid methyl ester (Intermediate IV, 0.60 g) in tetrahydrofuran (10 mL) under argon atmosphere. The resulting mixture was stirred at reflux temperature for 2.5 h. Then, aqueous NH₄Cl solution was added and the resulting mixture was extracted with ethyl acetate. The combined organic extracts were washed with brine, dried (MgSO₄), and concentrated. The residue was purified by chromatography on silica gel (cyclohexane/ethyl acetate 60:40→0:100) to separate the two title compounds.

3-[(S)-1-(4-Chloro-phenyl)-ethyl]-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one: Yield: 40 mg (7% of theory). Mass spectrum (ESI⁺): m/z=388/390 (Cl) [M+H]⁺. ¹H NMR (400 MHz, DMSO-d₆) δ 0.80 (s, 3H), 1.18 (s, 3H), 1.41 (d, J=7.0 Hz, 3H), 2.01 (s, 2H), 2.08 (td, J=11.5, 5.4 Hz, 1H), 2.37-2.51 (m, 2H), 2.95-3.02 (m, 1H), 4.23 (s, 1H), 5.38 (q, J=7.0 Hz, 1H), 6.86 (d, J=8.4 Hz, 2H), 7.14 (d, J=8.4 Hz, 2H), 7.27-7.39 (m, 5H).

3-[(S)-1-(4-Chloro-phenyl)-ethyl]-(R)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one: Yield: 93 mg (17% of theory). Mass spectrum (ESI⁺): m/z=388/390 (Cl) [M+H]⁺. ¹H NMR (400 MHz, DMSO-d₆) δ 0.81 (s, 3H), 1.16 (s, 3H), 1.18 (d, J=7.3 Hz, 3H), 2.03 (s, 2H), 2.31-2.41 (m, 2H), 2.51-2.59 (m, 1H), 2.64-2.71 (m, 1H), 4.20 (s, 1H), 5.31 (q, J=7.1 Hz, 1H), 7.25 (d, J=8.4 Hz, 2H), 7.28-7.35 (m, 3H), 7.37-7.43 (m, 4H).

The following compound was obtained in analogy to Intermediate V:

(1) 3-[(S)-1-(4-Bromo-phenyl)-ethyl]-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

The compound was obtained from [(S)-1-(4-bromo-phenyl)-ethyl]-(3,5-dihydroxy-5-methyl-3-phenyl-hexyl)-carbamic acid methyl ester (mixture of two diastereomers) in a mixture with 3-[(S)-1-(4-bromo-phenyl)-ethyl]-(R)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one that was resolved into the pure diastereomers by chromatography as described above.

Intermediate VI (S)-6-(2-Hydroxy-2-methyl-propyl)-6-phenyl-3-{(S)-1-[4-(4,4,5,5-tetramethyl-[1,3,2]dioxaborolan-2-yl)-phenyl]-ethyl}-[1,3]oxazinan-2-one

A flask charged with a stir bar, 3-[(S)-1-(4-bromo-phenyl)-ethyl]-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one (4.00 g), bis(pinacolato)diboron (3.05 g), 1,1′-bis(diphenylphosphino)ferrocene (0.25 g), KO₂CCH₃ (3.18 g), and dimethyl sulfoxide (30 mL) was sparged with argon for 15 min. Then, [1,1′-bis(diphenylphosphino)ferrocene]-dichloro-palladium(II)dichloromethane complex (0.38 g) was added and the resulting mixture was heated to 90° C. and stirred at this temperature overnight. After cooling to ambient temperature, ethyl acetate (150 mL) was added and the mixture was washed with water (3×50 mL) and brine (50 mL) and dried (MgSO₄). The solvent was removed under reduced pressure and the residue was purified by chromatography on silica gel (cyclohexane/ethyl acetate 33:66→0:100) to give the title compound as a colorless solid.

Yield: 3.50 mg (79% of theory); Mass spectrum (ESI⁺): m/z=480 [M+H]⁺

The following compound was obtained in analogy to Intermediate VI:

(1) (R)-6-Methoxymethyl-6-phenyl-3-{(S)-1-[4-(4,4,5,5-tetramethyl-[1,3,2]dioxaborolan-2-yl)-phenyl]-ethyl}-[1,3]oxazinan-2-one

3-[(S)-1-(4-Bromo-phenyl)-ethyl]-(R)-6-methoxymethyl-6-phenyl-[1,3]oxazinan-2-one was used as starting compound.

Intermediate VII 6-Chloro-4-methyl-2H-pyridazin-3-one and 6-chloro-5-methyl-2H-pyridazin-3-one

A suspension of 3,6-dichloro-4-methylpyridazine (6.60 g) in 3.3 M aqueous NaOH solution (66 mL) was stirred at reflux temperature for 2 h. The heating bath was removed and 50% aqueous acetic acid (25 mL) was added. The aqueous solution was adjusted to pH value 6 and the precipitate formed thereafter was separated by filtration and washed with little water. The precipitate was chromatographed on silica gel (cyclohexane/ethyl acetate 90:10→0:100) to separate the two title compounds.

6-Chloro-4-methyl-2H-pyridazin-3-one: Yield: 2.70 g (46% of theory). Mass spectrum (ESI⁺): m/z=145/147 (Cl) [M+H]⁺. ¹H NMR (400 MHz, DMSO-d₆) δ 2.06 (d, J=1.3 Hz, 3H), 7.44 (incompletely resolved q, J=1.3 Hz, 1H), 13.03 (broad s, 1H).

6-Chloro-5-methyl-2H-pyridazin-3-one: Yield: 1.90 g (32% of theory). Mass spectrum (ESI⁺): m/z=145/147 (Cl) [M+H]⁺. ¹H NMR (400 MHz, DMSO-d₆) δ 2.19 (d, J=1.3 Hz, 3H), 6.91 (incompletely resolved q, J=1.3 Hz, 1H), 13.02 (broad s, 1H).

The following compound was obtained in analogy to Intermediate VII:

(1) 6-Chloro-2H-pyridazin-3-one

Mass spectrum (ESI⁺): m/z=131/133 (Cl) [M+H]⁺

Intermediate VIII 6-Chloro-2,4-dimethyl-2H-pyridazin-3-one

Methyl iodide (1.3 mL) was added to a mixture of 6-chloro-4-methyl-2H-pyridazin-3-one (2.70 g) and K₂CO₃ (3.40 g) in N,N-dimethylformamide (27 mL). The resulting mixture was stirred at ambient temperature overnight. Then, water was added and the mixture was extracted with ethyl acetate. The combined organic extracts were washed with water and brine and dried (MgSO₄). After removal of the solvent, the title compound was obtained as a solid.

Yield: 2.97 g (100% of theory); Mass spectrum (ESI⁺): m/z=159/161 (Cl) [M+H]⁺.

The following compound was obtained in analogy to Intermediate VIII:

(1) 6-Chloro-2,5-dimethyl-2H-pyridazin-3-one

Mass spectrum (ESI⁺): m/z=159/161 (Cl) [M+H]⁺.

Intermediate IX (5-Bromo-2-nitro-phenyl)-methyl-amine

Methylamine (2 M in tetrahydrofuran, 11.4 mL) was added to a mixture of 4-bromo-2-fluoro-1-nitro-benzene (2.50 g) and K₂CO₃ (1.90 g) in N,N-dimethylformamide (40 mL). The resulting mixture was stirred at ambient temperature overnight. Then, the mixture was concentrated under reduced pressure and dichloromethane was added. The resulting mixture was washed with 0.5 M aqueous HCl solution and brine and dried (MgSO₄). The solvent was removed to give the product as a solid.

Yield: 2.60 g (99% of theory); Mass spectrum (ESI⁺): m/z=231/233 (Br) [M+H]⁺.

The following compound was obtained in analogy to Intermediate IX:

(1) (4-Bromo-2-nitro-phenyl)-methyl-amine

Mass spectrum (ESI⁺): m/z=231/233 (Br) [M+H]⁺.

Intermediate X 4-Bromo-2-methylamino-aniline

A mixture of (5-bromo-2-nitro-phenyl)-methyl-amine (2.60 g) and Raney nickel (0.25 g) in tetrahydrofuran (100 mL) was shaken under hydrogen atmosphere (50 psi) at room temperature overnight. Then, the catalyst was separated by filtration and the filtrate was concentrated under reduced pressure to give the crude title compound as a brown oil that was used without further purification.

Yield: 2.20 g (97% of theory); Mass spectrum (ESI⁺): m/z=201/203 (Br) [M+H]⁺.

The following compound was obtained in analogy to Intermediate X:

(1) 5-Bromo-2-methylamino-aniline

Mass spectrum (ESI⁺): m/z=201/203 (Br) [M+H]⁺.

Intermediate XI 6-Bromo-1,2-dimethyl-1H-benzoimidazole

A solution of 4-bromo-2-methylamino-aniline (1.10 g) in acetic acid (15 mL) was stirred at 130° C. for 2 h. After cooling to ambient temperature, the solution was concentrated under reduced pressure and the residue was taken up in ethyl acetate. The resulting solution was washed with 10% aqueous K₂CO₃ solution and brine and dried (MgSO₄). The solvent was removed and the remainder was purified by chromatography on silica gel (CH₂Cl₂/MeOH/NH₄OH 99:1:0.1→9:1:0.1) to give the title compound as a solid.

Yield: 0.58 g (47% of theory); Mass spectrum (ESI⁺): m/z=225/227 (Br) [M+H]⁺.

The following compound was obtained in analogy to Intermediate XI:

(1) 5-Bromo-1,2-dimethyl-1H-benzoimidazole

Mass spectrum (ESI⁺): m/z=225/227 (Br) [M+H]⁺

Intermediate XII 6-Chloro-2-cyclopropylmethyl-2H-pyridazin-3-one

Cyclopropylmethyl bromide (0.82 mL) was added to a mixture of 6-chloro-2H-pyridazin-3-one (1.0 g) and K₂CO₃ (2.10 g) in N,N-dimethylformamide (10 mL). The resulting mixture was stirred at 60° C. overnight. Then, water was added and the mixture was extracted with ethyl acetate. The combined organic extracts were washed with water and brine and dried (MgSO₄). After removal of the solvent, the residue was purified by chromatography on silica gel (CH₂Cl₂/MeOH/NH₄OH 99:1:0.1) to afford the title compound as an oil.

Yield: 0.85 g (60% of theory); Mass spectrum (ESI⁺): m/z=185/187 (Cl) [M+H]⁺.

Intermediate XIII 6-Chloro-2-cyclopropyl-2H-pyridazin-3-one

A microwave-suited vessel charged with a stir bar, 6-chloro-2H-pyridazin-3-one (0.15 g), cyclopropylboronic acid (0.30 g), pyridine (0.75 mL), triethylamine (0.8 mL), and tetrahydrofuran (5 mL) was sparged with argon for 5 min. Then, Cu(O₂CCH₃)₂ (0.42 g) was added and the mixture was stirred in a microwave oven under microwave irradiation at 140° C. for 10 min. After cooling to room temperature, the solvent was evaporated and water was added. The resultant mixture was extracted with ethyl acetate and the combined organic extracts were washed with water and aqueous NaHCO₃ solution. After drying (MgSO₄) and removing the solvent, the residue was purified by chromatography on silica gel (CH₂Cl₂/MeOH/NH₄OH 99:1:0.1→9:1:0.1) to afford the title compound.

Yield: 35 mg (18% of theory); Mass spectrum (ESI⁺): m/z=171/173 (Cl) [M+H]⁺.

The following compound was obtained in analogy to Intermediate XIII:

(1) 1-Cyclopropyl-4-(4-methoxy-benzyloxy)-1H-pyridin-2-one

Mass spectrum (ESI⁺): m/z=272 [M+H]⁺.

Intermediate XIV 4-(4-{(S)-1-[(S)-6-(2-Hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-phenyl)-3,6-dihydro-2H-pyridine-1-carboxylic acid tert-butyl ester

N,N-Dimethylformamide (5 mL) was added to a flask charged with a stir bar, 3-[(S)-1-(4-bromo-phenyl)-ethyl]-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one (0.30 g), 4-(4,4,5,5-tetramethyl-[1,3,2]dioxaborolan-2-yl)-3,6-dihydro-2H-pyridine-1-carboxylic acid tert-butyl ester (0.22 g), K₂CO₃ (0.29 g), and [1,1′-bis(diphenylphosphino)-ferrocene]-dichloropalladium(II) (57 mg) under argon atmosphere. The resulting mixture was stirred at 80° C. overnight. After cooling to ambient temperature, water was added and the resulting mixture was extracted with ethyl acetate. The combined organic extracts were washed with brine, dried (MgSO₄), and concentrated. The residue was purified by chromatography on silica gel (cyclohexane/ethyl acetate 40:60→0:100) to afford the title compound.

Yield: 0.35 g (93% of theory); Mass spectrum (ESI⁺): m/z=535 [M+H]⁺.

Intermediate XV 4-(4-{(S)-1-[(S)-6-(2-Hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-phenyl)-piperidine-1-carboxylic acid tert-butyl ester

A mixture of 4-(4-{(S)-1-[(S)-6-(2-hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-phenyl)-3,6-dihydro-2H-pyridine-1-carboxylic acid tert-butyl ester (0.34 g) and 10% palladium on carbon (60 mg) in methanol (10 mL) was shaken in hydrogen atmosphere (50 psi) for 4 h. Then, the catalyst was separated by filtration and the filtrate was concentrated to yield the title compound.

Yield: 0.30 g (88% of theory); LC (method 1): t_(R)=4.31 min; Mass spectrum (ESI⁺): m/z=537 [M+H]⁺.

Intermediate XVI 5-(4-{(S)-1-[(S)-6-(2-Hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-phenyl)-pyridine-2-carboxylic acid

2 M aqueous Na₂CO₃ solution (1.3 mL) was added to a solution of (S)-6-(2-hydroxy-2-methylpropyl)-6-phenyl-3-{(S)-1-[4-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)phenyl]-ethyl}-1,3-oxazinan-2-one (0.60 g) and 5-bromo-pyridine-2-carboxylic acid methyl ester (0.41 g) in N,N-dimethylformamide (4 mL). The resulting mixture was sparged with argon for 10 min, before [1,1′-bis(diphenylphosphino)ferrocene]-dichloropalladium(II)dichloromethane complex (61 mg) was added. The mixture was heated to 100° C. and stirred at this temperature overnight. After cooling to ambient temperature, the mixture was diluted with ethyl acetate and extracted with water and brine. The aqueous extracts were combined, acidified (pH ca. 5-6) using citric acid, and extracted with CH₂Cl₂/MeOH (ca. 10:1). The combined organic extracts were washed with brine and dried (MgSO₄). The solvent was removed and the residue was purified by chromatography on silica gel (CH₂Cl₂/MeOH 98:2→50:50) to afford the title compound as a resin-like solid.

Yield: 0.44 g (73% of theory); Mass spectrum (ESI⁺): m/z=475 [M+H]⁺.

Intermediate XVII 3-[(S)-1-(4′-Amino-3′-nitro-biphenyl-4-yl)-ethyl]-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

A flask charged with a stir bar, 3-[(S)-1-(4-bromo-phenyl)-ethyl]-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one (1.00 g), 2-nitro-4-(4,4,5,5-tetramethyl-[1,3,2]dioxaborolan-2-yl)-phenylamine (0.92 g), and 2 M aqueous Na₂CO₃ solution (2.3 mL) was sparged with argon for 15 min. Then, [1,1′-bis(diphenylphosphino)ferrocene]-dichloro-palladium(II)dichloromethane complex (57 mg) was added and the mixture was stirred at 100° C. overnight. After cooling to ambient temperature, water was added and the resulting mixture was extracted with ethyl acetate. The combined organic extracts were washed with brine, dried (MgSO₄), and concentrated. The residue was purified by chromatography on silica gel (CH₂Cl₂/MeOH 98:2→80:20) to afford the title compound as an oil that was crystallized using a mixture of ethyl acetate and iPr₂O (ca. 10:1).

Yield: 0.53 g (93% of theory); Mass spectrum (ESI⁺): m/z=490 [M+H]⁺.

Intermediate XVIII 3-[(S)-1-(3′,4′-Diamino-biphenyl-4-yl)-ethyl]-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

A mixture of 3-[(S)-1-(4′-amino-3′-nitro-biphenyl-4-yl)-ethyl]-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one (0.50 g) and 10% palladium on carbon (0.10 g) in a mixture of methanol (10 mL) and tetrahydrofuran (10 mL) was shaken in hydrogen atmosphere (3 bar) at room temperature for 3.5 h. Then, the catalyst was separated by filtration and the filtrate was concentrated under reduced pressure to afford the title compound as an oil.

Yield: 0.46 g (97% of theory); Mass spectrum (ESI⁺): m/z=460 [M+H]⁺.

Intermediate XIX 1-Cyclopropyl-4-hydroxy-1H-pyridin-2-one

Trifluoroacetic acid (1 mL) was added to a flask charged with a stir bar and 1-cyclopropyl-4-(4-methoxy-benzyloxy)-1H-pyridin-2-one (0.17 g) and chilled in an ice/EtOH bath. The resulting mixture was stirred with cooling for 1.5 h and at ambient temperature for another 4.5 h. Then, the solution was concentrated under reduced pressure and the residue was triturated with tert-butyl methyl ether and dried to give the title compound as a solid.

Yield: 0.10 g (quantitative); Mass spectrum (ESI⁺): m/z=152 [M+H]⁺.

Intermediate XX Trifluoro-methanesulfonic acid 1-cyclopropyl-2-oxo-1,2-dihydro-pyridin-4-yl ester

Trifluoromethanesulfonic anhydride (0.12 mL) was added to a flask charged with a stir bar, 1-cyclopropyl-4-hydroxy-1H-pyridin-2-one (0.10 g), NEt₃ (0.24 mL), and dichloromethane (8 mL) and chilled in an ice/EtOH bath. The resulting mixture was stirred with cooling for 2 h and at ambient temperature for another 2 h. Then, the solution was diluted with dichloro-methane and washed in succession with water, aqueous NaHCO₃ solution, and water. The organic solution was dried (MgSO₄), the solvent was removed, and the residue was purified by chromatography on silica gel (dichloromethane/methanol 99:1→90:10) to afford the title compound as a resin-like solid.

Yield: 0.07 g (36% of theory); Mass spectrum (ESI⁺): m/z=284 [M+H]⁺.

The following compound was obtained in analogy to Intermediate XX:

(1) Trifluoro-methanesulfonic acid 1-methyl-2-oxo-1,2-dihydro-pyridin-4-yl ester

Mass spectrum (ESI⁺): m/z=258 [M+H]⁺

Intermediate XXI 5-Bromo-1-cyclopropylmethyl-1H-pyridin-2-one

KO^(t)Bu (0.68 g) was added to a solution of 5-bromo-1H-pyridin-2-one (1.00 g) in tetrahydrofuran (20 mL) at room temperature. After stirring for 30 min, cyclopropylmethyl bromide (0.77 mL) and N,N-dimethylformamide (3 mL) were added to the suspension and the resulting mixture was warmed to 70° C. After stirring the mixture at 70° C. for 2 h, the reaction was finished. The mixture was cooled to room temperature, diluted with ethyl acetate (50 mL), and washed with water (2×20 mL) and brine (20 mL). Then, the solution was dried (MgSO₄) and the solvent was removed to give the title compound as a colorless oil.

Yield: 1.18 g (90% of theory); Mass spectrum (ESI⁺): m/z=228/230 (Br) [M+H]⁺.

Intermediate XXII 1-Methoxy-2-phenyl-pent-4-en-2-ol

2-Methoxy-1-phenyl-ethanone (5.00 g) dissolved in tetrahydrofuran (50 mL) was added to 2 M allylmagnesium chloride in tetrahydrofuran (21 mL) at room temperature. The solution was stirred at room temperature for 3 h and then 10% aqueous NH₄Cl solution (50 mL) was added. The resulting mixture was extracted with tert-butyl methyl ether (3×50 mL) and the combined extracts were washed with water (50 mL) and brine (50 mL). The solvent was evaporated to afford the title compound as a colorless oil.

Yield: 6.40 g (quantitative); Mass spectrum (ESI⁺): m/z=175 [M+H−H₂O]⁺.

Intermediate XXIII 5-Methoxy-4-phenyl-pentane-1,2,4-triol

OsO₄ (4% in water, 2 mL; alternatively, K₂OsO₄ may be used) followed by N-methyl-morpholine-N-oxide (5.20 g) was added to a solution of 1-methoxy-2-phenyl-pent-4-en-2-ol (1.10 g) in tetrahydrofuran (10 mL) chilled in an ice bath. The cooling bath was removed and the solution was stirred at room temperature overnight. Then, 10% aqueous Na₂S₂O₅ solution (10 mL) was added and the resulting mixture was stirred at room temperature for another 1.5 h. After removal of the organic solvent under reduced pressure, the remaining mixture was extracted with ethyl acetate. The combined extracts were washed with brine and dried (MgSO₄). The solvent was evaporated to afford the title compound in good purity (ca. 95%).

Yield: 1.20 g (96% of theory); Mass spectrum (ESI⁻): m/z=225 [M−H]⁻.

Intermediate XXIV 3-Hydroxy-4-methoxy-3-phenyl-butyraldehyde

NaIO₄ (5.20 g) was added to a mixture of 5-methoxy-4-phenyl-pentane-1,2,4-triol (1.10 g), dichloromethane (10 mL), and water (5 mL) chilled in an ice bath. The mixture was stirred vigorously while warming to ambient temperature in the cooling bath and further stirred at this temperature overnight. Then, water (20 mL) and dichloromethane (50 mL) were added, the organic layer was separated, and the aqueous layer was extracted with dichloromethane (2×25 mL). The combined organic phases were washed with water and dried (MgSO₄). After removal of the solvent, the title compound was obtained which was used without further purification.

Yield: 0.94 g (quantitative).

Intermediate XXV 4-[(S)-1-(4-Bromo-phenyl)-ethylamino]-1-methoxy-2-phenyl-butan-2-ol

(S)-1-(4-Bromo-phenyl)-ethylamine (0.93 g), NaHB(O₂CH₃)₃ (0.98 g), and acetic acid (0.27 mL) were added in the given order to a solution of 3-hydroxy-4-methoxy-3-phenyl-butyraldehyde (0.90 g) in tetrahydrofuran (20 mL) at ca. 10-15° C. The cooling bath was removed and the mixture was stirred at room temperature for 2 h. Then, water (50 mL) and 1 M aqueous NaOH solution (20 mL) were added and the resulting mixture was stirred for another 30 min. The mixture was extracted with ethyl acetate and the combined extracts were washed with water and brine. After drying (MgSO₄), the solvent was removed to give the title compound which was used without further purification.

Yield: 1.80 g (quantitative); Mass spectrum (ESI⁺): m/z=378/380 (Br) [M+H]⁺.

Intermediate XXVI 4-{(S)-1-[(S)-6-(2-Hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-benzoic acid methyl ester

NEt₃ (0.47 mL) and [1,1′-bis(diphenylphosphino)ferrocene]-dichloropalladium(II)dichloromethane complex (0.15 g) were added to a solution of 3-[(S)-1-(4-bromo-phenyl)-ethyl]-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one (1.04 g) in MeCN (2.5 mL), methanol (20 mL), and N,N-dimethylformamide (5 mL). The resulting mixture was sparged with argon for 5 min and then transferred to a pressure-resistant vessel that was filled with CO (5.5. bar). The mixture was heated to 70° C. and stirred at this temperature for 18 h before another portion of [1,1′-bis(diphenylphosphino)ferrocene]-dichloropalladium(II)dichloromethane complex (0.15 g) was added. After stirring at 70° C. for another 4 h, the mixture was cooled to ambient temperature, filtered, and concentrated under reduced pressure. The residue was taken up in ethyl acetate and the resulting mixture was washed with water and brine and dried (MgSO₄). The solvent was removed and the residue was purified by chromatography on silica gel (cyclohexane/ethyl acetate 40:60→0:100) to afford the title compound as an oil.

Yield: 0.73 g (55% of theory); Mass spectrum (ESI⁻): m/z=456 [M+HCOO]⁻

Intermediate XXVII 4-{(S)-1-[(S)-6-(2-Hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-benzoic acid

1 M aqueous NaOH solution (5 mL) was added to a solution of 4-{(S)-1-[(S)-6-(2-hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-benzoic acid methyl ester (0.73 g) in tetrahydrofuran (5 mL). The resulting solution was stirred at room temperature overnight. Then, the solution was concentrated and the residue was taken up in water and filtered. The aqueous filtrate was acidified with 1 M hydrochloric acid and the resulting mixture was extracted with ethyl acetate. The combined extracts were washed with brine and dried (MgSO₄). The solvent was removed to afford the title compound as a foam-like solid.

Yield: 0.38 g (72% of theory); LC (method 1): t_(R)=2.60 min; Mass spectrum (ESI⁺): m/z=398 [M+H]⁺

Intermediate XXVIII 4-{(S)-1-[(S)-6-(2-Hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-benzoic acid hydrazide

2-(1H-benzotriazol-1-yl)-1,1,3,3-tetramethyluronium tetrafluoroborate (0.33 g) was added to 4-{(S)-1-[(S)-6-(2-hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-benzoic acid (0.37 g) and EtNiPr₂ (0.41 mL) dissolved in N,N-dimethylformamide (5 mL). After stirring the solution at room temperature for 10 min, hydrazine hydrate (0.23 mL) was added. The solution was stirred at room temperature overnight and then diluted with water. The resulting mixture was extracted with ethyl acetate and the combined extracts were washed with brine and dried (MgSO₄). The solvent was removed and the residue was purified by chromatography on silica gel (CH₂Cl₂/MeOH 98:2→90:10) to afford the title compound as a colorless foam-like solid.

Yield: 0.19 g (50% of theory); Mass spectrum (ESI⁻): m/z=410 [M−H]⁻

Intermediate XXIX 4-Bromo-5-fluoro-1-methyl-1H-pyridin-2-one

Methyl iodide (0.9 mL) was added to a mixture of potassium carbonate (2.34 g) and 4-bromo-5-fluoro-1H-pyridin-2-one (2.50 g) in N,N-dimethylformamide (25 mL) at room temperature. The mixture was stirred at room temperature overnight and then water was added. The resulting mixture was extracted with ethyl acetate and the combined extracts were washed with brine and dried (MgSO₄). The solvent was evaporated to afford the crude title compound that was recrystallized from Et₂O.

Yield: 1.22 g (45% of theory); Mass spectrum (ESI⁺): m/z=206/208 (Br) [M+H]⁺.

Example 1 3-{(S)-1-[4-(1,5-Dimethyl-6-oxo-1,6-dihydro-pyridazin-3-yl)-phenyl]-ethyl}-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

2 M aqueous Na₂CO₃ solution (0.31 mL) was added to a solution of (S)-6-(2-hydroxy-2-methylpropyl)-6-phenyl-3-[(S)-1-(4-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)phenyl)ethyl]-1,3-oxazinan-2-one (0.15 g) and 6-chloro-2,4-dimethyl-2H-pyridazin-3-one (75 mg) in N,N-dimethylformamide (1 mL). The resulting mixture was sparged with argon for 10 min, before [1,1′-bis(diphenylphosphino)ferrocene]-dichloropalladium(II)dichloromethane complex (15 mg) was added. The mixture was heated to 100° C. and stirred at this temperature overnight. After cooling to ambient temperature, water was added and the resulting mixture was extracted with ethyl acetate. The combined organic extracts were washed with brine, dried (MgSO₄), and concentrated. The residue was purified by chromatography on silica gel (CH₂Cl₂/MeOH 98:2→80:20) to afford the title compound.

Yield: 0.10 g (67% of theory); LC (method 1): t_(R)=3.17 min; Mass spectrum (ESI⁺): m/z=476 [M+H]⁺.

The following compounds were obtained in analogy to Example 1: The reactions were carried out using either the bromo, chloro, or trifluoromethanesulfonyloxy derivatized coupling partners (=electrophilic component).

Example 2 3-{(S)-1-[4-(1,4-Dimethyl-6-oxo-1,6-dihydro-pyridazin-3-yl)-phenyl]-ethyl}-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

LC (method 1): t_(R)=2.99 min; Mass spectrum (ESI⁺): m/z=476 [M+1-1]⁺

Example 3 3-{(S)-1-[4-(2,3-Dimethyl-3H-benzoimidazol-5-yl)-phenyl]-ethyl}-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

Mass spectrum (ESI⁺): m/z=498 [M+H]⁺.

Example 4 (S)-6-(2-Hydroxy-2-methyl-propyl)-3-{(S)-1-[4-(3-methyl-3H-benzoimidazol-5-yl)-phenyl]-ethyl}-6-phenyl-[1,3]oxazinan-2-one

LC (method 1): t_(R)=2.54 min; Mass spectrum (ESI⁺): m/z=484 [M+H]⁺.

Example 5 (S)-6-(2-Hydroxy-2-methyl-propyl)-3-{(S)-1-[4-(1-methyl-1H-benzoimidazol-5-yl)-phenyl]-ethyl}-6-phenyl-[1,3]oxazinan-2-one

LC (method 1): t_(R)=2.44 min; Mass spectrum (ESI⁺): m/z=484 [M+H]±.

Example 6 3-{(S)-1-[4-(1,2-Dimethyl-1H-benzoimidazol-5-yl)-phenyl]-ethyl}-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

LC (method 1): t_(R)=2.45 min; Mass spectrum (ESI⁺): m/z=498 [M+1-1]⁺.

Example 7 3-{(S)-1-[4-(1-Cyclopropylmethyl-6-oxo-1,6-dihydro-pyridazin-3-yl)-phenyl]-ethyl}-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

LC (method 1): t_(R)=3.46 min; Mass spectrum (ESI⁺): m/z=502 [M+1-1]⁺.

Example 8 3-{(S)-1-[4-(1-Cyclopropyl-6-oxo-1,6-dihydro-pyridazin-3-yl)-phenyl]-ethyl}-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

LC (method 1): t_(R)=3.22 min; Mass spectrum (ESI⁺): m/z=488 [M+H]⁺.

Example 9 3-{(S)-1-[4-(1-Cyclopropyl-2-oxo-1,2-dihydro-pyridin-4-yl)-phenyl]-ethyl}-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

LC (method 2): t_(R)=2.41 min; Mass spectrum (ESI⁺): m/z=487 [M+H]⁺.

Trifluoro-methanesulfonic acid 1-cyclopropyl-2-oxo-1,2-dihydro-pyridin-4-yl ester was employed as the coupling partner under the conditions described above

Example 10 3-{(S)-1-[4-(1-Cyclopropylmethyl-6-oxo-1,6-dihydro-pyridin-3-yl)-phenyl]-ethyl}-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

Mass spectrum (ESI⁺): m/z=501 [M+1-1]⁺.

Example 11 (R)-6-Methoxymethyl-3-{(S)-1-[4-(6-methyl-pyridazin-3-yl)-phenyl]-ethyl}-6-phenyl-1-[1,3]oxazinan-2-one

LC (method 1): t_(R)=2.92 min; Mass spectrum (ESI⁺): m/z=418 [M+H]⁺

Example 12 (R)-6-Methoxymethyl-3-{(S)-1-[4-(1-methyl-6-oxo-1,6-dihydro-pyridin-3-yl)-phenyl]-ethyl}-6-phenyl-[1,3]oxazinan-2-one

LC (method 1): t_(R)=2.98 min; Mass spectrum (ESI⁺): m/z=433 [M+H]⁺

Example 13 (R)-6-Methoxymethyl-3-{(S)-1-[4-(1-methyl-2-oxo-1,2-dihydro-pyridin-4-yl)-phenyl]-ethyl}-6-phenyl-[1,3]oxazinan-2-one

LC (method 1): t_(R)=2.92 min; Mass spectrum (ESI⁺): m/z=433 [M+H]⁺

Trifluoro-methanesulfonic acid 1-methyl-2-oxo-1,2-dihydro-pyridin-4-yl ester was used as the coupling partner under the conditions described above.

Example 14 3-{(S)-1-[4-(5-Fluoro-1-methyl-2-oxo-1,2-dihydro-pyridin-4-yl)-phenyl]-ethyl}-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

Mass spectrum (ESI⁺): m/z=479 [M+H]⁺

4-Bromo-5-fluoro-1-methyl-1H-pyridin-2-one was used as the coupling partner under the conditions described above.

Example 15 5-(4-{(S)-1-[(S)-6-(2-Hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-phenyl)-pyridine-2-carboxylic acid ethylamide

2-(1H-Benzotriazol-1-yl)-1,1,3,3-tetramethyluronium tetrafluoroborate (75 mg) was added to a solution of 5-(4-{(S)-1-[(S)-6-(2-hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-phenyl)-pyridine-2-carboxylic acid (0.10 g) and diisopropylethyl-amine (50 μL) in N,N-dimethylformamide (1 mL) at room temperature. The resulting solution was stirred for 25 min, before ethylamine (70% in water, 50 μL) was added. The solution was stirred at room temperature overnight and then concentrated under reduced pressure. The crude product was purified by HPLC on reversed phase (MeCN/H₂O) to afford the title compound as a foam-like solid.

Yield: 25 mg (24% of theory); TLC: r_(f)=0.37 (silica gel; CH₂Cl₂/MeOH 95:5);

Mass spectrum (ESI⁺): m/z=502 [M+1-1]⁺.

The following compounds were obtained in analogy to Example 15:

Example 16 5-(4-{(S)-1-[(S)-6-(2-Hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-phenyl)-pyridine-2-carboxylic acid methylamide

TLC: r_(f)=0.37 (silica gel; CH₂Cl₂/MeOH 95:5); Mass spectrum (ESI⁺): m/z=488 [M+H]⁺. Methylamine was the coupling partner.

Example 17 (4-{(S)-1-[(S)-6-(2-Hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-phenyl)-pyridine-2-carboxylic acid dimethylamide

TLC: r_(f)=0.30 (silica gel; CH₂Cl₂/MeOH 95:5); Mass spectrum (ESI⁺): m/z=502 [M+H]⁺. Dimethylamine was the coupling partner.

Example 18 (S)-6-(2-Hydroxy-2-methyl-propyl)-6-phenyl-3-[(S)-1-(4-piperidin-4-yl-phenyl)-ethyl]-[1,3]oxazinan-2-one

Trifluoroacetic acid (0.40 mL) was added to a solution of 4-(4-{(S)-1-[(S)-6-(2-hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-phenyl)-piperidine-1-carboxylic acid tert-butyl ester (0.29 g) in dichloromethane (10 mL). The resulting solution was stirred at room temperature overnight. Then, more dichloromethane was added and the solution was neutralized using aqueous saturated NaHCO₃ solution. The organic phase was separated, washed with water, and dried (MgSO₄). The solvent was removed under reduced pressure to yield the title compound.

Yield: 0.22 g (93% of theory); LC (method 1): t_(R)=2.09 min; Mass spectrum (ESI⁺): m/z=437 [M+H]⁺.

Example 19 3-{(S)-1-[4-(1-Acetyl-piperidin-4-yl)-phenyl]-ethyl}-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

Triethylamine (0.10 mL), acetic anhydride (50 μL), and 4-dimethylaminopyridine (5 mg) were added consecutively to (S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-3-[(S)-1-(4-piperidin-4-yl-phenyl)-ethyl]-[1,3]oxazinan-2-one (0.12 g) dissolved in tetrahydrofuran (5 mL) at room temperature. The solution was stirred at room temperature for 4 h and then diluted with ethyl acetate. The resulting solution was washed with aqueous saturated NaHCO₃ solution and brine and dried (Na₂SO₄). After removal of the solvent, the residue was purified by chromatography on silica gel (CH₂Cl₂/MeOH 98:2→90:10) to afford the title compound as a colorless foam-like solid.

Yield: 80 mg (61% of theory); TLC: r_(f)=0.60 (silica gel; CH₂Cl₂/MeOH 90:10);

Mass spectrum (ESI⁺): m/z=479 [M+H]⁺.

Example 20 4-(4-{(S)-1-[(S)-6-(2-Hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-phenyl)-piperidine-1-carboxylic acid methyl ester

Triethylamine (0.10 mL) and methyl chloroformate (24 μL) were added consecutively to (S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-3-[(S)-1-(4-piperidin-4-yl-phenyl)-ethyl]-[1,3]oxazinan-2-one (0.12 g) dissolved in dichloromethane (5 mL) at room temperature. The resulting solution was stirred at room temperature overnight and then diluted with dichloromethane. The resulting solution was washed with water and brine and dried (Na₂SO₄). After removal of the solvent, the residue was purified by chromatography on silica gel (CH₂Cl₂/MeOH 99:1→90:10) to afford the title compound as a foam-like solid.

Yield: 100 mg (70% of theory); TLC: r_(f)=0.60 (silica gel; CH₂Cl₂/MeOH 90:10); Mass spectrum (ESI⁺): m/z=495 [M+H]⁺.

Example 21 (S)-6-(2-Hydroxy-2-methyl-propyl)-3-{(5)-1-[4-(1-methyl-piperidin-4-yl)-phenyl]-ethyl}-6-phenyl-[1,3]oxazinan-2-one

Acetic acid (27 μL) and NaHB(O₂CCH₃)₃ (160 mg) were added to a solution of (S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-3-[(S)-1-(4-piperidin-4-yl-phenyl)-ethyl]-[1,3]oxazinan-2-one (200 mg) and formaldehyde (37% in water, 70 μL) in tetrahydrofuran (5 mL) at room temperature. After stirring the solution at room temperature overnight, ethyl acetate and 1 M aqueous NaOH solution were added and the resulting mixture was stirred for another 10 min. Then, the organic layer was separated and washed with water and brine and dried (MgSO₄). The solvent was evaporated and the residue was purified by HPLC on reversed phase (MeCN/H₂O/F₃CCO₂H) to afford the title compound as its trifluoroacetic acid salt.

Yield: 120 mg (46% of theory); LC (method 1): t_(R)=2.18 min; Mass spectrum (ESI⁺): m/z=451 [M+H]⁺.

Example 22 (S)-6-(2-Hydroxy-2-methyl-propyl)-3-{(S)-1-[4-(1-methanesulfonyl-piperidin-4-yl)-phenyl]-ethyl}-6-phenyl-[1,3]oxazinan-2-one

MeSO₂Cl (29 μL) was added to a solution of (S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-3-[(S)-1-(4-piperidin-4-yl-phenyl)-ethyl]-[1,3]oxazinan-2-one (150 mg) and triethylamine (100 μL) in dichloromethane (3 mL) at room temperature. After stirring the solution at room temperature overnight, more dichloromethane was added and the resulting solution was washed with aqueous NaHCO₃ solution, water, and brine. The organic solution was then dried (MgSO₄) and concentrated. The residue was purified by HPLC on reversed phase (MeCN/H₂O/NH₃) to afford the title compound.

Yield: 52 mg (29% of theory); Mass spectrum (ESI⁺): m/z=515 [M+H]⁺.

Example 23 (S)-6-(2-Hydroxy-2-methyl-propyl)-6-phenyl-3-((S)-1-{4-[1-((S)-tetrahydro-furan-2-carbonyl)-piperidin-4-yl]-phenyl}-ethyl)-[1,3]oxazinan-2-one

2-(1H-Benzotriazol-1-yl)-1,1,3,3-tetramethyluronium tetrafluoroborate (125 mg) was added to a solution of (S)-tetrahydro-furan-2-carboxylic acid (45 mg) and diisopropylethyl-amine (200 μL) in N,N-dimethylformamide (2 mL) at room temperature. The resulting solution was stirred for 30 min, before (S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-3-[(S)-1-(4-piperidin-4-yl-phenyl)-ethyl]-[1,3]oxazinan-2-one (150 mg) dissolved in dimethylformamide (1 mL) was added. The resulting solution was stirred at room temperature overnight and then concentrated under reduced pressure. The crude product was purified by HPLC on reversed phase (MeCN/H₂O/NH₃) to afford the title compound.

Yield: 110 mg (60% of theory); LC (method 1): t_(R)=3.20 min; Mass spectrum (ESI⁺): m/z=535 [M+1-1]⁺

The following compounds were obtained in analogy to Example 23:

Example 24 (S)-6-(2-Hydroxy-2-methyl-propyl)-6-phenyl-3-((S)-1-{4-[1-((R)-tetrahydro-furan-2-carbonyl)-piperidin-4-yl]-phenyl}-ethyl)-[1,3]oxazinan-2-one

LC (method 1): t_(R)=3.20 min; Mass spectrum (ESI⁺): m/z=535 [M+14]⁺

Example 25 (S)-6-(2-Hydroxy-2-methyl-propyl)-6-phenyl-3-((S)-1-{4-[1-(2-hydroxy-2-propyl-carbonyl)-piperidin-4-yl]-phenyl}-ethyl)-[1,3]oxazinan-2-one

LC (method 1): t_(R)=3.17 min; Mass spectrum (ESI⁺): m/z=535 [M+14]⁺

Example 26 (S)-6-(2-Hydroxy-2-methyl-propyl)-3-((S)-1-{4-[1-((S)-1-methyl-pyrrolidine-2-carbonyl)-piperidin-4-yl]-phenyl}-ethyl)-6-phenyl-[1,3]oxazinan-2-one

Mass spectrum (ESI⁺): m/z=548 [M+H]⁺

Example 27 (S)-6-(2-Hydroxy-2-methyl-propyl)-3-((S)-1-{4-[1-((R)-1-methyl-pyrrolidine-2-carbonyl)-piperidin-4-yl]-phenyl}-ethyl)-6-phenyl-[1,3]oxazinan-2-one

LC (method 1): t_(R)=2.37 min; Mass spectrum (ESI⁺): m/z=548 [M+H]⁺

Example 28 3-{(S)-1-[4-(3H-Benzotriazol-5-yl)-phenyl]-ethyl}-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one

A solution of NaNO₂ (0.16 g) in water (2 mL) was added dropwise to an ice-cold solution of 3-[(S)-1-(3′,4′-diamino-biphenyl-4-yl)-ethyl]-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one (0.43 g) in acetic acid (10 mL). The resulting mixture was stirred with cooling for 2 h and at room temperature for another 1 h. Then, water (100 mL) was added and the resulting mixture is extracted with ethyl acetate. The combined organic extracts were washed with saturated aqueous NaHCO₃ solution, water, and brine and dried (Na₂SO₄). The solvent was removed and the residue was purified by chromatography on silica gel (ethyl acetate/MeOH 98:2→80:20) to afford the title compound as a foam-like solid.

Yield: 0.30 g (69% of theory); LC (method 1): t_(R)=3.02 min; Mass spectrum (ESI⁺): m/z=471 [M+H]⁺.

Example 29 (S)-6-(2-Hydroxy-2-methyl-propyl)-3-{(S)-1-[4-(2-methyl-3H-benzoimidazol-5-yl)-phenyl]-ethyl}-6-phenyl-[1,3]oxazinan-2-one

3-[(S)-1-(3′,4′-Diamino-biphenyl-4-yl)-ethyl]-(S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-[1,3]oxazinan-2-one (120 mg) taken up in acetic acid (2 mL) was stirred under microwave irradiation at 150° C. for 30 min. After cooling to ambient temperature, the mixture was concentrated under reduced pressure and the residue was purified by HPLC on reversed phase (MeCN/H₂O) to afford the title compound.

Yield: 77 mg (61% of theory); Mass spectrum (ESI⁺): m/z=484 [M+H]⁺.

Examples 30 and 31 3-[(S)-1-(4-Bromo-phenyl)-ethyl]-(R)-6-methoxymethyl-6-phenyl-[1,3]oxazinan-2-one and 3-[(S)-1-(4-Bromo-phenyl)-ethyl]-(S)-6-methoxymethyl-6-phenyl-[1,3]oxazinan-2-one

Triphosgene (157 mg) was added to an ice-cold solution of 4-[(S)-1-(4-bromo-phenyl)-ethylamino]-1-methoxy-2-phenyl-butan-2-ol (1:1 diastereomeric mixture, 200 mg) and EtNiPr₂ (91 μL) in dichloromethane (5 mL). The resulting solution was stirred with cooling for 2 h and at room temperature overnight. Then, the solution was concentrated under reduced pressure and the residue was purified by HPLC on reversed phase (MeCN/H₂O/NH₃) to afford the title compounds in separate fractions.

Example 30 3-[(S)-1-(4-Bromo-phenyl)-ethyl]-(R)-6-methoxymethyl-6-phenyl-[1,3]oxazinan-2-one

Yield: 45 mg (21% of theory). Mass spectrum (ESI⁺): m/z=404 [M+H]⁺. ¹H NMR (400 MHz, DMSO-d₆) δ 1.41 (d, J=7.1 Hz, 3H), 2.19 (td, J=11.2, 5.2 Hz, 1H), 2.24-2.34 (m, 1H), 2.34-2.41 (m, 1H), 3.02-3.09 (m, 1H), 3.27 (s, 3H), 3.49 (d, B part of an AB signal, J=10.6 Hz, 1H), 3.53 (d, A part of an AB signal, J=10.6 Hz, 1H), 5.34 (q, J=7.0 Hz, 1H), 6.80 (dm, J=8.4 Hz, 2H), 7.27 (dm, J=8.4 Hz, 2H), 7.32-7.42 (m, 5H).

Example 31 3-[(S)-1-(4-Bromo-phenyl)-ethyl]-(S)-6-methoxymethyl-6-phenyl-[1,3]oxazinan-2-one

Yield: 45 mg (21% of theory). Mass spectrum (ESI⁺): m/z=404 [M+H]⁺. ¹H NMR (400 MHz, DMSO-d₆) δ 1.20 (d, J=7.2 Hz, 3H), 2.13-2.23 (m, 1H), 2.32-2.40 (m, 1H), 2.63-2.72 (m, 1H), 2.73-2.81 (m, 1H), 3.26 (s, 3H), 3.48 (d, B part of an AB signal, J=10.6 Hz, 1H), 3.55 (d, A part of an AB signal, J=10.6 Hz, 1H), 5.35 (q, J=7.2 Hz, 1H), 7.19 (dm, J=8.4 Hz, 2H), 7.32-7.45 (m, 5H), 7.53 (dm, J=8.4 Hz, 2H).

Example 32 (S)-6-(2-Methyl-allyl)-3-{(S)-1-[4-(5-methyl-[1,3,4]oxadiazol-2-yl)-phenyl]-ethyl}-6-phenyl-[1,3]oxazinan-2-one

A mixture of 4-{(S)-1-[(S)-6-(2-hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazin-an-3-yl]-ethyl}-benzoic acid hydrazide (90 mg), toluene-4-sulfonic acid monohydrate (10 mg), and 1,1,1-trimethoxy-ethane (1 ml) was stirred at room temperature for 1 h, at 80° C. for 2 h, and finally at reflux temperature for 1.5 h. After cooling to ambient temperature, ethyl acetate was added and the resulting mixture was washed with aqueous NaHCO₃ solution and brine. The solvent was removed under reduced pressure and the residue was purified by chromatography on silica gel (CH₂Cl₂/MeOH 99:1→95:5) to afford the title compound as a colorless resin-like solid.

Yield: 55 mg (60% of theory); TLC: r_(f)=0.70 (silica gel; CH₂Cl₂/MeOH 95:5); Mass spectrum (ESI⁺): m/z=418 [M+H]⁺.

Example 33 (S)-6-(2-Hydroxy-2-methyl-propyl)-3-{(S)-1-[4-(1-methyl-2-oxo-piperidin-4-yl)-phenyl]-ethyl}-6-phenyl-[1,3]oxazinan-2-one

PtO₂ (50 mg) was added to (S)-6-(2-hydroxy-2-methyl-propyl)-3-{LS)-1-[4-(1-methyl-2-oxo-1,2-dihydro-pyridin-4-yl)-phenyl]-ethyl}-6-phenyl-[1,3]oxazinan-2-one (150 mg; the compound was obtained from (S)-6-(2-hydroxy-2-methylpropyl)-6-phenyl-3-[(S)-1-(4-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)phenyl)ethyl]-1,3-oxazinan-2-one and 4-bromo-1-methyl-1H-pyridin-2-one employing the procedure described for Example 1) dissolved in methanol (5 mL). The resulting mixture was shaken in hydrogen atmosphere (50 psi) for 8 h. Then, the mixture was filtered and the filtrate was concentrated under reduced pressure. The residue was purified by HPLC on reversed phase (MeCN/H₂O) to afford the title compound.

Yield: 100 mg (66% of theory); LC (method 1): t_(R)=2.89 min; Mass spectrum (ESI⁺): m/z=482 [M+NH₄]⁺.

The following compound was obtained in analogy to Example 33:

Example 34 (S)-6-(2-Hydroxy-2-methyl-propyl)-3-{(S)-1-[4-(1-methyl-6-oxo-piperidin-3-yl)-phenyl]-ethyl}-6-phenyl-[1,3]oxazinan-2-one

LC (method 1): t_(R)=2.89 min; Mass spectrum (ESI⁺): m/z=465 [M+H]⁺

The starting compound, (S)-6-(2-hydroxy-2-methyl-propyl)-3-{(S)-1-[4-(1-methyl-6-oxo-1,6-dihydro-pyridin-3-yl)-phenyl]-ethyl}-6-phenyl-[1,3]oxazinan-2-one, was obtained from (S)-6-(2-hydroxy-2-methylpropyl)-6-phenyl-3-[(S)-1-(4-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)phenyl)ethyl]-1,3-oxazinan-2-one and 5-bromo-1-methyl-1H-pyridin-2-one employing the procedure described for Example 1.

Example 35 4-(4-{(S)-1-[(S)-6-(2-Hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-phenyl)-piperidine-1-carboxylic acid methylamide

MeNH₂*HCl (27 mg) and K₂CO₃ (93 mg) were added to a solution of 4-nitrophenyl chloroformate (66 mg) in acetonitrile (2 mL) at room temperature. The resulting mixture was stirred at room temperature for 4 h, before (S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-3-[(S)-1-(4-piperidin-4-yl-phenyl)-ethyl]-[1,3]oxazinan-2-one (110 mg) and NEt₃ (53 μL) were added. The mixture was further stirred at room temperature overnight. Then, diluted aqueous ammonia solution was added and the resulting mixture was filtered. The filtrate was concentrated under reduced pressure and the residue was purified by HPLC on reversed phase (MeOH/H₂O/NH₃) to afford the title compound.

Yield: 100 mg (80% of theory); Mass spectrum (ESI⁺): m/z=494 [M+H]⁺.

Example 36 4-((S)-4-{1-[(S)-6-(2-Hydroxy-2-methyl-propyl)-2-oxo-6-phenyl-[1,3]oxazinan-3-yl]-ethyl}-phenyl)-piperidine-1-carboxylic acid dimethylamide

Dimethylcarbamoyl chloride (26 μL) was added to a solution of (S)-6-(2-hydroxy-2-methyl-propyl)-6-phenyl-3-[(S)-1-(4-piperidin-4-yl-phenyl)-ethyl]-[1,3]oxazinan-2-one (120 mg) and pyridine (40 μL) in N,N-dimethylformamide (2 mL) at room temperature. The solution was stirred at room temperature for 5 h, before another portion of dimethylcarbamoyl chloride (26 μL) and pyridine (20 μL) were added. The solution was stirred at room temperature overnight. Then, diluted aqueous ammonia solution was added and the resulting mixture was concentrated under reduced pressure. The residue was purified by HPLC on reversed phase (MeOH/H₂O/NH₃) to afford the title compound.

Yield: 70 mg (50% of theory); LC (method 1): t_(R)=3.17 min; Mass spectrum (ESI⁺): m/z=508 [M+H]⁺.

Example 37 3-{(S)-1-[4-(1,2-dimethyl-1H-benzo[d]imidazol-5-yl)phenyl]ethyl}-6-(2-hydroxy-2-methylpropyl)-6-isopropyl-1,3-oxazinan-2-one

Step 1

To a solution of methyl 4-methyl-3-oxopentanoate (72 g, 0.5 mol) and ethylene glycol (56 g, 1 mol) in toluene (500 mL) was added 4-methylbenzenesulfonic acid (1.9 g, 0.01 mol). The mixture was stirred at reflux with a Dean-Stark trap to remove water. The reaction mixture was washed with a small amount of water and brine, dried over anhydrous Na₂SO₄, and concentrated in vacuum to give the crude (2-isopropyl-[1,3]dioxolan-2-yl)-acetic acid methyl ester (67 g 71% yield), which was used for the next step without further purification.

Step 2

In a flame-dried, three-neck flask equipped with an addition funnel, magnetic stirring bar, rubber septum, and a nitrogen inlet, was placed LiAlH₄ (3.12 g, 82.1 mmol) and tetrahydrofuran (700 mL). After being cooled at 0° C., a solution of (2-isopropyl-[1,3]dioxolan-2-yl)-acetic acid methyl ester (12 g, 63.8 mmol) in tetrahydrofuran (160 mL) was added dropwise with stirring. The mixture was warmed to room temperature and stirred for 24 hours. The reaction was quenched by adding water (5 mL), 15% aqueous NaOH (10 mL), and water (5 mL) slowly. The organic layer was separated, and the residue was extracted with EtOAc (3×100 mL). The combined organic phase was dried over Na₂SO₄ and concentrated to afford the crude product, which was purified by column chromatography to give 2-(2-isopropyl-[1,3]dioxolan-2-yl)-ethanol (6.8 g, 67%). ¹H NMR (CDCl₃) δ 0.90 (d, J=6.8 Hz, 6H), 1.87-1.96 (m, 3H), 2.81 (br, 1H), 3.69-3.72 (m, 2H), 3.92-4.01 (m, 4H).

Step 3

To a solution of 2-(2-isopropyl-1,3-dioxolan-2-yl)-ethanol (8.0 g, 50 mmol) and triethylamine (23.5 mL, 170 mmol) in anhydrous CH₂Cl₂ (120 mL) was added methanesulfonyl chloride (11.6 mL, 150 mmol) at 0° C., and the reaction mixture was stirred at room temperature till the reaction was finished. The reaction mixture was washed with water and brine, dried over Na₂SO₄, filtered, and concentrated to give the crude methanesulfonic acid 2-(2-isopropyl-[1,3]dioxolan-2-yl)-ethyl ester (12 g), which was used for the next step without further purification.

Step 4

To a solution of methanesulfonic acid 2-(2-isopropyl-[1,3]dioxolan-2-yl)-ethyl ester (12 g, 50 mmol) and (S)-1-(4-bromophenyl)ethanamine (19.9 g, 100 mmol) in CH₃CN (250 mL) was added K₂CO₃ (8 g, 58 mmol), and the mixture was refluxed for 10 h. The solution was filtered, and the filtrate was concentrated to afford the crude product, which was purified by column chromatography to give [(S)-1-(4-bromophenyl)-ethyl]-[2-(2-isopropyl-[1,3]dioxolan-2-yl)-ethyl]-amine (6.5 g, 38%).

Step 5

To a solution of [(S)-1-(4-bromophenyl)-ethyl]-[2-(2-isopropyl-[1,3]dioxolan-2-yl)-ethyl]-amine (6.5 g, 19 mmol) in MeOH (60 mL) was added concentrated aqueous HCl (60 mL). The mixture was stirred at 65° C. till the reaction was finished. The mixture was cooled to 0° C., and the pH of the mixture was adjusted to 7 by adding saturated aqueous NaHCO₃. The mixture was concentrated, and the residue was extracted with EtOAc (3×100 mL). The organic layer was washed with brine, dried over Na₂SO₄, and concentrated to give 1-[(S)-1-(4-bromophenyl)-ethylamino]-4-methyl-pentan-3-one (5.5 g, 97%), which was used for the next step without further purification. ¹H NMR (CDCl₃): δ 1.07 (d, J=6.8 Hz, 6H), 1.29 (d, J=6.4 Hz, 3H), 1.89 (br, 1H), 2.54-2.62 (m, 4H), 2.66-2.69 (m, 1H), 3.68-3.72 (m, 1H), 7.18-7.20 (m, 2H), 7.41-7.44 (m, 2H).

Step 6

To a suspension of Mg (11 g, 458 mmol) and I₂ (0.5 g) in anhydrous tetrahydrofuran (50 mL) was added 3-chloro-2-methylprop-1-ene (1 mL) to initiate the reaction. Tetrahydrofuran (300 mL) was added, more solution of 3-chloro-2-methylprop-1-ene (15 mL) in tetrahydrofuran (20 mL) was dropped into the reaction at 0° C. under N₂ over 30 min A solution of 1-[(S)-1-(4-bromophenyl)-ethylamino]-4-methyl-pentan-3-one (5 g) in tetrahydrofuran (50 mL) was added dropwise at −78° C. over 45 min. The reaction mixture was stirred at room temperature for 2 h. The reaction was cautiously quenched with saturated aqueous NH₄Cl, and the reaction mixture was filtered. The filtrate was extracted with EtOAc (3×100 mL) and the combined extracts were washed with brine, dried over anhydrous Na₂SO₄, and concentrated in vacuo to give 3-{(S)-2-[1-(4-bromophenyl)-ethylamino]-ethyl}-2,5-dimethyl-hex-5-en-3-ol (6.4 g, 90% yield), which was used for the next step without further purification.

Step 7

To a solution of 3-{(S)-2-[1-(4-bromophenyl)-ethylamino]-ethyl}-2,5-dimethyl-hex-5-en-3-ol (6.4 g, 16.8 mmol) and triethylamine (5.34 g, 52 mmol) in CH₂Cl₂ (260 mL) was added triphosgene (2.52 g, 8.5 mmol) at 0° C. under N₂, and the mixture was stirred at room temperature overnight. The reaction was quenched with water, and the mixture was extracted with CH₂Cl₂ (3×50 mL). The combined organic layer was washed with brine, dried over Na₂SO₄, filtered, and concentrated to afford the crude product, which was purified by column chromatography to give two isomers of 3-[(S)-1-(4-bromophenyl)ethyl]-6-isopropyl-6-(2-methylallyl)-1,3-oxazinan-2-one.

Isomer 1: (lower r_(f) on silica gel TLC, 1.85 g, 27% yield). ¹H NMR (CDCl₃) δ 0.83 (d, J=7.2 Hz, 3H), 0.89 (d, J=7.2 Hz, 3H), 1.45 (d, J=6.8 Hz, 3H), 1.64-1.70 (m, 2H), 1.79 (s, 3H), 1.88-1.95 (m, 1H), 2.20-2.34 (m, 2H), 2.59-2.65 (m, 1H), 3.01-3.08 (m, 1H), 4.70 (s, 1H), 4.87 (s, 1H), 5.68-5.77 (m, 1H), 7.14 (d, J=8.4 Hz, 2H), 7.41 (d, J=8.4 Hz, 2H).

Isomer 2: (higher r_(f) on silica gel TLC, 1.25 g, 18% yield). ¹H NMR (CDCl₃) δ 0.87 (d, J=6.8 Hz, 3H), 0.92 (d, J=6.8 Hz, 3H), 1.50 (d, J=7.2 Hz, 3H), 1.60-1.66 (m, 1H), 1.78 (s, 3H), 1.73-1.79 (m, 1H), 1.78-2.05 (m, 1H), 2.08 (d, J=14.0 Hz, 1H), 2.30 (d, J=14.0 Hz, 1H), 2.62-2.68 (m, 1H), 2.98-3.05 (m, 1H), 4.64 (s, 1H), 4.84 (s, 1H), 5.70-5.75 (m, 1H), 7.13 (d, J=8.4 Hz, 2H), 7.40 (d, J=8.4 Hz, 2H).

Step 8

To a solution of 3-[(S)-1-(4-bromophenyl)ethyl]-6-isopropyl-6-(2-methylallyl)-1,3-oxazinan-2-one isomer 1 (500 mg, 1.32 mmol) in dry CH₂Cl₂ (64 mL) was added 3-chloroperoxybenzoic acid (455 g, 2.64 mmol) at room temperature. The reaction mixture was stirred until the starting material was consumed (monitored by TLC). The mixture was diluted with (CH₃)₃COCH₃ (70 mL), washed with 30% aqueous Na₂S₂O₃ and aqueous NaHCO₃ (3×), dried over Na₂SO₄, filtered, and concentrated to give 3-[(S)-1-(4-bromophenyl)ethyl]-6-isopropyl-6-((2-methyloxiran-2-yl)methyl)-1,3-oxazinan-2-one isomer 1 (520 mg, 99%), which was used directly for the next step without further purification.

Step 9

To a solution of 3-[(S)-1-(4-bromophenyl)ethyl]-6-isopropyl-6-((2-methyloxiran-2-yl)methyl)-1,3-oxazinan-2-one isomer 1 (520 mg, 1.32 mmol) in tetrahydrofuran (32 mL) was added dropwise LiEt₃BH (13.6 mL, 13.6 mmol) at 0° C. under N₂ over 30 min. The resulting solution was stirred at 10-13° C. for 21.5 h. Then aqueous H₂O₂ (40 mL) was added to the mixture and the resulting solution was diluted with (CH₃)₃COCH₃ (380 mL), and washed with water, 30% aqueous Na₂S₂O₃, and brine. The organic phase was dried over Na₂SO₄ and filtered. The filtrate was concentrated to give the crude product, which was purified by column chromatography to afford 3-[(S)-1-(4-bromophenyl)ethyl]-6-(2-hydroxy-2-methylpropyl)-6-isopropyl-1,3-oxazinan-2-one isomer 1 (320 mg, 61%). ¹H NMR (CDCl₃) δ 0.82 (d, J=6.8 Hz, 3H), 0.95 (d, J=6.8 Hz, 3H), 1.31 (s, 3H), 1.34 (s, 3H), 1.51 (d, J=10.0 Hz, 3H), 1.61 (d, J=15.2 Hz, 1H), 1.78-1.84 (m, 1H), 1.91 (d, J=15.2 Hz, 1H), 2.02-2.15 (m, 2H), 2.36 (br, 1H), 2.62-2.68 (m, 1H), 3.03-3.09 (m, 1H), 5.73 (t, J=7.2 Hz, 1H), 7.17-7.19 (m, 2H), 7.44-7.48 (m, 2H).

Step 10

To a solution of 3-[(S)-1-(4-bromophenyl)ethyl]-6-(2-hydroxy-2-methylpropyl)-6-isopropyl-1,3-oxazinan-2-one isomer 1 (315 mg, 0.793 mmol) in dimethyl sulfoxide (10 mL) was added 4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)-1,3,2-dioxaborolane (602 mg, 2.38 mmol), CH₃CO₂K (770 mg, 79.3 mmol), and Pd[1,1′-bis(diphenylphosphino)ferreocene]₂Cl₂ (50 mg, 0.06 mmol) under N₂ and the reaction mixture was stirred at 90° C. for 4 h. The reaction was quenched with aqueous NH₄Cl, and the resulting mixture was extracted with EtOAc. The combined extracts were washed with water and brine. The organic phase was dried over Na₂SO₄ and filtered. The filtrate was concentrated to give the crude product, which was purified by preparative TLC to give 6-(2-hydroxy-2-methylpropyl)-6-isopropyl-3-{(S)-1-[4-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)phenyl]ethyl}-1,3-oxazinan-2-one isomer 1 (250 mg, 71%).

Step 11

To a solution of 5-bromo-1,2-dimethyl-1H-benzo[d]imidazole (30 mg, 0.13 mmol), 6-(2-hydroxy-2-methylpropyl)-6-isopropyl-3-{(S)-1-[4-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)phenyl]ethyl}-1,3-oxazinan-2-one isomer 1 (15 mg, 0.034 mmol) and Na₂CO₃ (10.74 mg, 0.10 mmol) in toluene (3 mL), EtOH (2 mL) and H₂O (1 mL) was added Pd(PPh₃)₄ (0.39 mg, 0.003 mmol) at room temperature. The reaction mixture was heated to 100° C. under N₂ and stirred at this temperature for 2 h. The formed mixture was concentrated to afford an oil which was poured into H₂O (10 mL) and extracted with EtOAc (10 mL×3). The combined organic layers were concentrated to afford an oil which was purified by preparative TLC and preparative HPLC to afford 3-{(5)-1-[4-(1,2-dimethyl-1H-benzo[d]imidazol-5-yl)phenyl]-ethyl}-6-(2-hydroxy-2-methylpropyl)-6-isopropyl-1,3-oxazinan-2-one isomer 1 (5.5 mg, 8.9%). ¹H NMR (CD₃OD) δ 0.79 (d, 3H), 0.89 (d, 3H), 1.21 (s, 1H), 1.22 (s, 6H), 1.51 (m, 3H), 1.62 (m, 1H), 1.82 (m, 2H), 2.03 (m, 1H), 2.12 (m, 1H), 2.52 (m, 3H), 2.72 (m, 1H), 3.72 (m, 3H), 5.62 (m, 1H), 7.31 (m, 2H), 7.42 (m, 2H), 7.55 (m, 2H), 7.69 (s, 1H); Mass spectrum (ESI⁺): m/z=464 [M+H]⁺.

The following compound was obtained in analogy to Step 11 of Example 37:

Example 38 6-(2-hydroxy-2-methylpropyl)-6-isopropyl-3-{(S)-1-[4-(1-methyl-1H-benzo[d]imidazol-5-yl)phenyl]ethyl}-1,3-oxazinan-2-one

5-Bromo-1-methyl-1H-benzoimidazole was employed as the coupling partner.

¹H NMR (CD₃OD) 0.77 (d, 3H), 0.88 (d, 3H), 1.15-1.25 (6H), 1.55 (d, 3H), 1.60-1.90 (3H), 2.07 (m, 1H), 2.15 (m, 1H), 2.74 (2H), 4.08 (s, 3H), 5.58 (q, 1H), 7.40 (d, 2H), 7.64 (d, 2H), 7.87 (m, 2H), 7.94 (s, 1H), 9.28 (s, 1H); Mass spectrum (ESI⁺): m/z=450 [M+H]±.

Biological Test Example 1

In vitro inhibition of 11 β-HSD1 by test compounds was determined with HTRF (Homogeneous Time-Resolved Fluorescence) technology (cisbio international, France) detecting cortisol generated from cortisterone by human liver microsomes. Briefly, compounds were incubated for 1 hour at 37° C. in Tris buffer (20 mM tris, 5 mM EDTA, pH 6.0) containing NADPH (200 μM) and cortisone (80 nM). Cortisol generated in the reaction is then detected with a competitive immunoassay, involving two HTRF conjugates: cortisol linked to XL665 and anti-cortisol antibody labeled with Europium cryptate. The incubation period for detection reaction was typically 2 hours. The amount of cortisol is determined by reading the time-resolved fluorescence of the wells (Ex 320/75 nm; Em 615/8.5 nm and 665/7.5 nm). The ratio of the two emission signals is then calculated (Em665*10000/Em615). Each assay contained incubations with vehicle controls instead of compound as controls for non-inhibited cortisol generation (100% CTL; ‘high values’) and incubations with carbenoxolone as controls for fully inhibited enzyme and cortisol background (0% CTL; ‘low values’). Each assay also contained a calibration curve with cortisol to transform the fluorescent data into cortisol concentrations. Percent inhibition of each compound was determined relative to the carbenoxolone signal.

In Table 1 the 11β-HSD 1 inhibitory activities, determined as described above, are compiled, wherein 100% indicates no inhibition and a value of zero or below zero indicates complete inhibition.

TABLE 1 Average % control inhibition at 100 Example nM 1 14 2 63 3 −3 4  3 5 −5 6 −19  7 10 8  9 9 −14  10 17 11 43 12 59 13 58 14 15 15 −34  16 −24  17 −10  18 93 19 −1 20 −13  21 97 22 17 23 44 24 53 25 71 26 80 27 86 28 34 29 23 30 28 31 88 33 −27* 34 −17* 35  1 36 31 *Average % control inhibition refers to 1 μM inhibitor concentration

Biological Test Example 2

The inhibition of a microsomal preparation of 11β-HSD1 by compounds of the invention was measured essentially as previously described (K. Solly, S. S. Mundt, H. J. Zokian, G. J. Ding, A. Hermanowski-Vosatka, B. Strulovici, and W. Zheng, High-Throughput Screening of 11-Beta-Hydroxyseroid Dehydrogenase Type 1 in Scintillation Proximity Assay Format. Assay Drug Dev Technol 3 (2005) 377-384). All reactions were carried out at rt in 96 well clear flexible PET Microbeta plates (PerkinElmer). The assay begins by dispensing 49 μl of substrate solution (50 mM HEPES, pH 7.4, 100 mM KCl, 5 mM NaCl, 2 mM MgCl₂, 2 mM NADPH and 160 nM [³H]cortisone (1 Ci/mmol)) and mixing in 1 μL of the test compounds in DMSO previously diluted in half-log increments (8 points) starting at 0.1 mM. After a 10 minute pre-incubation, 50 μL of enzyme solution containing microsomes isolated from CHO cells overexpressing human 11β-HSD1 (10-20 μg/ml of total protein) was added, and the plates were incubated for 90 minutes at rt. The reaction was stopped by adding 50 μL of the SPA beads suspension containing 10 μM 18-β-glycyrrhetinic acid 5 mg/ml protein A coated YSi SPA beads (GE Healthcare) and 3.3 μg/ml of anti-cortisol antibody (East Coast Biologics) in Superblock buffer (Bio-Rad). The plates were shaken for 120 minutes at rt, and the SPA signal corresponding to [³H]cortisol was measured on a Microbeta plate reader.

TABLE 2 11β-HSD 1 inhibitory activities of compounds of the invention determined as described above. Example IC₅₀ 37 6.9 nM 38 7.7 nM

The compounds of the invention are useful for ameliorating or treating disorders or diseases in which decreasing the level of cortisol is effective in treating a disease state. Thus, the compounds of the invention can be used in the treatment or prevention of diabetes mellitus, obesity, symptoms of metabolic syndrome, glucose intolerance, hyperglycemica, hypertension, hyperlipidemia, insulin resistance, cardiovascular disease, dyslipidemia, atherosclerosis, lipodystrophy, osteoporosis, glaucoma, Cushing's syndrome, Addison's Disease, visceral fat obesity associated with glucocorticoid therapy, depression, anxiety, Alzheimer's disease, dementia, cognitive decline (including age-related cognitive decline), polycystic ovarian syndrome, infertility and hypergonadism. The compounds of the invention can be used as therapeutic agents for pseudo Cushing's Syndrome associated with alcoholic liver disease. In addition, the compounds modulate the function of B and T cells of the immune system and can therefore be used to treat diseases such as tuberculosis, leprosy and psoriasis. They can also be used to promote wound healing, particularly in diabetic patients.

Additional diseases or disorders that are related to 1113-HSD1 activity include those selected from the group consisting of lipid disorders, hypretriglyceridemia, hypercholesterolemia, low HDL levels, high LDL levels, vascular restenosis, pancreatitis, abdominal obesity, neurodegenerative disease, retinopathy, nephropathy, neuropathy, diabetes, coronary heart disease, stroke, peripheral vascular disease, Cushing's syndrome, hyperinsulinemia, viral diseases, and Syndrome X. A further disease related to 11β-HSD1 activity is pseudo Cushing's Syndrome associated with alcoholic liver disease.

A pharmaceutical composition of the invention may, alternatively or in addition to a compound of Formula I, comprise a pharmaceutically acceptable salt of a compound of Formula I or a prodrug or pharmaceutically active metabolite of such a compound or salt and one or more pharmaceutically acceptable carriers therefore. Alternatively, a pharmaceutical composition of the invention may comprise a compound of Formula I, Ia-1 or a pharmaceutical salt thereof as the only pharmaceutically active agent in the pharmaceutical composition. The disclosed 11β-HSD1 inhibitors can be used alone or in a combination therapy with one or more additional agents for the treatment of diabetes, dyslipidemia, cardiovascular disease, hypertension, obesity, cancer or glaucoma.

The compositions of the invention are 11β-HSD1 inhibitors. Said compositions contain compounds having a mean inhibition constant (IC₅₀) against 11β-HSD1 of below about 1,000 nM; preferably below about 100 nM; more preferably below about 50 nM; even more preferably below about 5 nM; and most preferably below about 1 nM.

The invention includes a therapeutic method for treating or ameliorating an 11β-HSD1 mediated disorder in a subject in need thereof comprising administering to a subject in need thereof an effective amount of a compound of Formula I, or an enantiomer, diastereomer, or pharmaceutically acceptable salt thereof of composition thereof. As used herein, “treating” or “treatment” includes both therapeutic and prophylactic treatment. Therapeutic treatment includes reducing the symptoms associated with a disease or condition and/or increasing the longevity of a subject with the disease or condition. Prophylactic treatment includes delaying the onset of a disease or condition in a subject at risk of developing the disease or condition or reducing the likelihood that a subject will then develop the disease or condition in a subject that is at risk for developing the disease or condition.

An embodiment of the invention includes administering an 11β-HSD1 inhibiting compound of Formula I or composition thereof in a combination therapy with one or more additional agents for the treatment of diabetes, dyslipidemia, cardiovascular disease, hypertension, obesity, cancer or glaucoma. Agents for the treatment of diabetes include insulins, such as Humulin® (Eli Lilly), Lantus® (Sanofi Aventis), Novolin (Novo Nordisk), and Exubera® (Pfizer); PPAR gamma agonists, such as Avandia® (rosiglitizone maleate, GSK) and Actos® (pioglitazone hydrochloride, Takeda/Eli Lilly); sulfonylureas, such as Amaryl® (glimepiride, Sanofi Aventis), Diabeta® (glyburide, Sanofi Aventis), Micronase®/Glynase® (glyburide, Pfizer), and Glucotrol®/Glucotrol XL® and (glipizide, Pfizer); meglitinides, such as Prandin®/NovoNorm® (repaglinide, Novo Nordisk), Starlix® (nateglinide, Novartis), and Glufast® (mitiglinide, Takeda); biguanides, such as Glucophase®/Glucophase XR® (metformin HCl, Bristol Myers Squibb) and Glumetza (metformin HCl, Depomed); thiazolidinediones; amylin analogs, GLP-1 analogs; DPP-IV inhibitors; PTB-1B inhibitors; protein kinase inhibitors (including AMP-activated protein kinase inhibitors); glucagon antagonists, glycogen synthase kinase-3 beta inhibitors; glucose-6-phoshatase inhibitors; glycogen phosphorylase inhibitors; sodium glucose co-transporter inhibitors, and alpha-glucosidase inhibitors, such as Precose®/Glucobay®/Prandase®/Glucor® (acarbose, Bayer) and Glyset® (miglitol, Pfizer). Agents for the treatment of dyslipidemia and cardiovascular disease include statins, fibrates, and ezetimbe. Agents for the treatment of hypertension include alpha-blockers, beta-blockers, calcium channel blockers, diuretics, angiotensin converting enzyme (ACE) inhibitors, dual ACE and neutral endopeptidase (NEP) inhibitors, angiotensin-receptor blockers (ARBs), aldosterone synthase inhibitors, aldosterone-receptor antagonists, or endothelin receptor antagonist. Agents for the treatment of obesity include orlistat, phentermine, sibutramine and rimonabant.

An embodiment of the invention includes administering an 11β-HSD1 inhibiting compound of Formula I or composition thereof in a combination therapy with one or more other 11β-HSD1 inhibitors (whether such inhibitors are also compounds of Formula I or are compounds of a different class/genus), or with combination products, such as Avandamet® (metformin HCl and rosiglitazone maleate, GSK); Avandaryl® (glimepiride and rosiglitazone maleate, GSK); Metaglip® (glipizide and metformin HCl, Bristol Myers Squibb); and Glucovance® (glyburide and metformin HCl, Bristol Myers Squibb).

The compounds of the present invention can be prepared and administered in a wide variety of oral and parenteral dosage forms. Thus, the compounds of the present invention can be administered by injection, that is, intravenously, intramuscularly, intracutaneously, subcutaneously, intraduodenally, or intraperitoneally. Additionally, the compounds of the present invention can be administered intranasally or transdermally. It will be obvious to those skilled in the art that the following dosage forms may comprise as the active ingredient, either compounds or a corresponding pharmaceutically acceptable salt of a compound of the present invention.

For preparing pharmaceutical compositions from the compounds of the present invention, pharmaceutically acceptable carriers can either be solid or liquid. Solid form preparations include powders, tablets, pills, capsules, cachets, suppositories, and dispersible granules. A solid carrier can be one or more substances which may also act as diluents, flavoring agents, solubilizers, lubricants, suspending agents, binders, preservatives, tablet disintegrating agents, or an encapsulating material. In powders, the carrier is a finely divided solid which is in a mixture with the finely divided active ingredient.

In tablets, the active ingredient is mixed with the carrier having the necessary binding properties in suitable proportions and compacted in the shape and size desired.

The powders and tablets preferably contain from about one to about seventy percent of the active ingredient. Suitable carriers are magnesium carbonate, magnesium stearate, talc, sugar, lactose, pectin, dextrin, starch, gelatin, tragacanth, methylcellulose, sodium caboxymethylcellulose, a low-melting wax, cocoa butter, and the like. Tablets, powders, cachets, lozenges, fast-melt strips, capsules and pills can be used as solid dosage forms containing the active ingredient suitable for oral administration.

For preparing suppositories, a low-melting wax, such as a mixture of fatty acid glycerides or cocoa butter, is first-melted and the active ingredient is dispersed homogeneously therein, as by stirring. The molten homogeneous mixture is then poured into convenient sized molds, allowed to cool, and thereby to solidify.

Liquid form preparations include solutions, suspensions, retention enemas, and emulsions, for example, water or water propylene glycol solutions. For parenteral injection, liquid preparations can be formulated in solution in aqueous polyethylene glycol solution.

Aqueous solutions suitable for oral administration can be prepared by dissolving the active ingredient in water and adding suitable colorants, flavors, stabilizing, and thickening agents as desired. Aqueous suspensions for oral administration can be prepared by dispersing the finely divided active ingredient in water with viscous material, such as natural or synthetic gums, resins, methylcellulose, sodium carboxymethylcellulose, and other well-known suspending agents.

The pharmaceutical composition is preferably in unit dosage form. In such form, the composition is subdivided into unit doses containing appropriate quantities of the active ingredient. The unit dosage form can be a packaged preparation, the package containing discrete quantities of, for example, tablets, powders, and capsules in vials or ampules. Also, the unit dosage form can be a tablet, cachet, capsule, or lozenge itself, or it can be the appropriate amount of any of these in packaged form.

The quantity of active ingredient in a unit dose preparation may be varied or adjusted from about 0.1 mg to about 1000.0 mg, preferably from about 0.1 mg to about 100 mg. The dosages, however, may be varied depending upon the requirements of the patient, the severity of the condition being treated, and the compound being employed. Determination of the proper dosage for a particular situation is within the skill in the art. Also, the pharmaceutical composition may contain, if desired, other compatible therapeutic agents.

In therapeutic treatment or as a method-of-use as an inhibitor of 11β-HSD1 or an inhibitor in the production of cortisol in the cell, the active ingredient is preferably administered orally in a solid dosage form as disclosed above in an amount of about 0.1 mg to about 100 mg per daily dose where the dose is administered once or more than once daily.

All publications, patents and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication or patent application were specifically and individually designated as having been incorporated by reference. It is understood that the examples and embodiments described herein are for illustrative purposes only, and it will be appreciated that the invention is susceptible to modification, variation and change without departing from the proper scope or fair meaning of the appended claims. 

What is claimed is:
 1. A compound represented by one of the following structural formulas:

wherein: R¹ is (a) absent or (b) is selected from (C₁-C₆)alkyl, (C₂-C₆)alkenyl, (C₂-C₆)alkynyl, (C₁-C₃)alkoxy(C₁-C₃)alkoxy, and (C₁-C₃)alkoxy(C₁-C₃)alkyl and is optionally substituted with up to four groups independently selected from fluorine, cyano, oxo, R⁴, R⁴O—, (R⁴)₂N—, R⁴O₂C—, R⁴S, R⁴S(═O)—, R⁴S(═O)₂—, R⁴C(═O)NR⁴—, (R⁴)₂NC(═O)—, (R⁴)₂NC(═O)O—, (R⁴)₂NC(═O)NR⁴—, R⁴OC(═O)NR⁴—, (R⁴)₂NC(═NCN)NR⁴—, (R⁴O)₂P(═O)O—, (R⁴O)₂P(═O)NR⁴—, R⁴OS(═O)₂NR⁴—, (R⁴)₂NS(═O)₂O—, (R⁴)₂NS(═O)₂NR⁴—, R⁴S(═O)₂NR⁴—, R⁴S(═O)₂NHC(═O)—, R⁴S(═O)₂NHC(═O)O—, R⁴S(═O)₂NHC(═O)NR⁴—, R⁴OS(═O)₂NHC(═O)—, R⁴OS(═O)₂NHC(═O)O—, R⁴OS(═O)₂NHC(═O)NR⁴—, (R⁴)₂NS(═O)₂NHC(═O)—, (R⁴)₂NS(═O)₂NHC(═O)O—, (R⁴)₂NS(═O)₂NHC(═O)NR⁴—, R⁴C(═O)NHS(═O)₂—, R⁴C(═O)NHS(═O)₂O—, R⁴C(═O)NHS(═O)₂NR⁴—, R⁴OC(═O)NHS(═O)₂—, R⁴OC(═O)NHS(═O)₂O—, R⁴OC(═O)NHS(═O)₂NR⁴—, (R⁴)₂NC(═O)NHS(═O)₂—, (R⁴)₂NC(═O)NHS(═O)₂O—, (R⁴)₂NC(═O)NHS(═O)₂NR⁴—, heterocyclyl, heteroaryl, arylamino and heteroarylamino; R² is (C₁-C₆)alkyl, aryl, heteroaryl, cycloalkyl or heterocyclyl and is optionally substituted with up to 4 groups independently selected from fluorine, chlorine, bromine, iodine, cyano, nitro, amino, hydroxy, carboxy, (C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl, (C₃-C₆)cycloalkyl, hydroxy(C₃-C₆)cycloalkyl, (C₄-C₇)cycloalkylalkyl, (C₂-C₆)alkenyl, halo(C₂-C₆)alkenyl, hydroxy(C₂-C₆)alkenyl, (C₂-C₆)alkynyl, (C₃-C₆)cycloalkyl(C₂-C₄)alkynyl, halo(C₁-C₆)alkyl, halo(C₃-C₆)cycloalkyl, halo(C₄-C₇)cycloalkylalkyl, (C₁-C₆)alkoxy, (C₃-C₆)cycloalkoxy, (C₄-C₇)cycloalkylalkoxy, halo(C₁-C₆)alkoxy, halo(C₃-C₆)cycloalkoxy, halo(C₄-C₇)cycloalkylalkoxy, (C₁-C₆)alkylthio, (C₃-C₆)cycloalkylthio, (C₄-C₇)cycloalkylalkylthio, halo(C₁-C₆)alkylthio, halo(C₃-C₆)cycloalkylthio, halo(C₄-C₇)cycloalkylalkylthio, (C₁-C₆)alkanesulfinyl, (C₃-C₆)cycloalkanesulfinyl, (C₄-C₇)cycloalkylalkanesulfinyl, halo(C₁-C₆)alkanesulfinyl, halo(C₃-C₆)cycloalkanesulfinyl, halo(C₄-C₇)cycloalkylalkanesulfinyl, (C₁-C₆)alkanesulfonyl, (C₃-C₆)cycloalkanesulfonyl, (C₄-C₇)cycloalkylalkanesulfonyl, halo(C₁-C₆)alkanesulfonyl, halo(C₃-C₆)cycloalkanesulfonyl, halo(C₄-C₇)cycloalkylalkanesulfonyl, (C₁-C₆)alkylamino, di(C₁-C₆)alkylamino, (C₁-C₆)alkoxy(C₁-C₆)alkoxy, halo(C₁-C₆)alkoxy(C₁-C₆)alkoxy, (C₁-C₆)alkoxycarbonyl, H₂NCO, H₂NSO₂, (C₁-C₆)alkylaminocarbonyl, di(C₁-C₆)alkylaminocarbonyl, (C₁-C₃)alkoxy(C₁-C₃)alkylaminocarbonyl, heterocyclylcarbonyl, (C₁-C₆)alkylaminosulfonyl, di(C₁-C₆)alkylaminosulfonyl, heterocyclylsulfonyl, (C₁-C₆)alkylcarbonylamino, (C₁-C₆)alkylcarbonylamino(C₁-C₆)alkyl, (C₁-C₆)alkylsulfonylamino, (C₁-C₆)alkylsulfonylamino(C₁-C₆)alkyl, (C₁-C₆)alkoxycarbonyl(C₁-C₆)alkoxy, (C₁-C₆)alkoxy(C₁-C₆)alkyl, halo(C₁-C₆)alkoxy(C₁-C₆)alkyl, hydroxy(C₁-C₆)alkoxy, heteroaryl, oxo, amino(C₁-C₆)alkyl, (C₁-C₆)alkylamino(C₁-C₆)alkyl, di(C₁-C₆)alkylamino(C₁-C₆)alkyl amino(C₂-C₆)alkoxy, (C₁-C₆)alkylamino(C₂-C₆)alkoxy, di(C₁-C₆)alkylamino(C₂-C₆)alkoxy, (C₁-C₆)alkylcarbonyl, (C₃-C₆)cycloalkylcarbonyl, (C₃-C₆)cycloalkylaminocarbonyl, {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl, di(C₃-C₆)cycloalkylaminocarbonyl, (C₃-C₆)cycloalkylaminosulfonyl, {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminosulfonyl, di(C₃-C₆)cycloalkylaminosulfonyl, cyano(C₁-C₆)alkyl, aminocarbonyl(C₁-C₆)alkyl, (C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl, di(C₁-C₆)alkylaminocarbonyl(C₁-C₆)alkyl, (C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl, {(C₃-C₆)cycloalkyl}{(C₁-C₆)alkyl}aminocarbonyl(C₁-C₆)alkyl and di(C₃-C₆)cycloalkylaminocarbonyl(C₁-C₆)alkyl; R³ is selected from (C₁-C₆)alkyl, (C₂-C₆)alkenyl, (C₂-C₆)alkynyl, (C₃-C₅)cycloalkyl(C₁-C₄)alkyl, (C₁-C₃)alkoxy(C₁-C₃)alkoxy, and (C₁-C₃)alkoxy(C₁-C₃)alkyl and is optionally substituted with up to four groups independently selected from fluorine, cyano, oxo, R⁴, R⁴O—, (R⁴)₂N—, R⁴O₂C—, R⁴C(═O)O—, R⁴S, R⁴S(═O)—, R⁴S(═O)₂—, R⁴C(═O)NR⁴—, (R⁴)₂NC(═O)—, (R⁴)₂NC(═O)O—, (R⁴)₂NC(═O)NR⁴—, R⁴OC(═O)NR⁴—, (R⁴)₂NC(═NCN)NR⁴—, (R⁴⁰)₂P(═O)O—, (R⁴O)₂P(═O)NR⁴—, R⁴OS(═O)₂NR⁴—, (R⁴)₂NS(═O)₂O—, (R⁴)₂NS(═O)₂NR⁴—, R⁴S(═O)₂NR⁴—, R⁴S(═O)₂NHC(═O)—, R⁴S(═O)₂NHC(═O)O—, R⁴S(═O)₂NHC(═O)NR⁴—, R⁴OS(═O)₂NHC(═O)—, R⁴OS(═O)₂NHC(═O)O—, R⁴OS(═O)₂NHC(═O)NR⁴—, (R⁴)₂NS(═O)₂NHC(═O)—, (R⁴)₂NS(═O)₂NHC(═O)O—, (R⁴)₂NS(═O)₂NHC(═O)NR⁴—, R⁴C(═O)NHS(═O)₂—, R⁴C(═O)NHS(═O)₂O—, R⁴C(═O)NHS(═O)₂NR⁴—, R⁴OC(═O)NHS(═O)₂—, R⁴OC(═O)NHS(═O)₂O—, R⁴OC(═O)NHS(═O)₂NR⁴—, (R⁴)₂NC(═O)NHS(═O)₂—, (R⁴)₂NC(═O)NHS(═O)₂O—, (R⁴)₂NC(═O)NHS(═O)₂NR⁴—, spirocycloalkyl; heterocyclyl (which in turn may be optionally substituted with alkyl, haloalkyl, halogen or oxo), heteroaryl (which in turn may be optionally substituted with alkyl, haloalkyl, alkoxy, alkylthio, alkylsulfonyl, halogen, trifluoromethyl, dialkylamino, nitro, cyano, CO₂H, CONH₂, N-monoalkyl-substituted amido, N,N-dialkyl-substituted amido, or oxo), arylamino (which in turn may be optionally substituted with alkyl, alkoxy, alkylthio, alkylsulfonyl, halogen, trifluoromethyl, dialkylamino, nitro, cyano, CO₂H, CONH₂, N-monoalkyl-substituted amido and N,N-dialkyl-substituted amido) and heteroarylamino (which in turn may be optionally substituted with alkyl, haloalkyl, alkoxy, alkylthio, alkylsulfonyl, halogen, trifluoromethyl, dialkylamino, nitro, cyano, CO₂H, CONH₂, N-monoalkyl-substituted amido, N,N-dialkyl-substituted amido, or oxo); R⁴ is independently selected from H, (C₁-C₆)alkyl, halo(C₁-C₆)alkyl, amino(C₁-C₆)alkyl, (C₁-C₆)alkylamino(C₁-C₆)alkyl, di(C₁-C₆)alkylamino(C₁-C₆)alkyl, hydroxy(C₁-C₆)alkyl and (C₁-C₆)alkoxy(C₁-C₆)alkyl; each substitutable ring nitrogen atom in the piperidinyl ring is optionally substituted with (C₁-C₄)alkyl, (C₁-C₄)alkylcarbonyl, CONH₂, (C₁-C₄)alkylaminocarbonyl or di(C₁-C₄)alkylaminocarbonyl; wherein each substitutable ring carbon atom in the piperidinyl ring is optionally substituted with fluorine, chlorine, cyano, hydroxy, amino, (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, halo(C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, CONH₂, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl or (C₁-C₄)alkylcarbonylamino; each G¹ is independently halogen, cyano, oxo, nitro, hydroxy, amino, (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, halo(C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkoxy, (C₁-C₄)alkoxycarbonyl, benzoxycarbony, CONH₂, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl, (C₃-C₄)cycloalkylaminocarbonyl, {(C₁-C₄)alkyl}{(C₃-C₄)cycloalkyl}aminocarbonyl or (C₁-C₄)alkylcarbonylamino; and r is 0, 1 or 2; or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof.
 2. The compound of claim 1, wherein the compound is represented by one of the following structural formulas:

wherein each G¹ is independently (C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)haloalkyl, (C₁-C₄)haloalkoxy, halogen, cyano or nitro; r is 0, 1 or 2; G^(2a) is (C₁-C₄)alkyl, (C₁-C₄)alkylcarbonyl, or (C₁-C₄)alkoxycarbonyl; and each G^(2b) is independently hydrogen, fluorine, chlorine, cyano, hydroxy, amino, (C₁-C₄)alkyl, (C₃-C₄)cycloalkyl, (C₃-C₄)cycloalkyl(C₁-C₂)alkyl, halo(C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)alkylcarbonyl, (C₁-C₄)alkoxycarbonyl, (C₁-C₄)haloalkoxy, CONH₂, (C₁-C₄)alkylaminocarbonyl, di(C₁-C₄)alkylaminocarbonyl or (C₁-C₄)alkylcarbonylamino; or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof.
 3. The compound of claim 1, wherein R² is phenyl, thienyl, or pyridyl, each optionally substituted with halogen, nitro, cyano, (C₁-C₆)alkyl, halo(C₁-C₆)alkyl, hydroxy(C₁-C₃)alkyl, (C₁-C₃)alkoxy, halo(C₁-C₃)alkoxy, CONH₂ or SO₂Me; and R³ is methyl, ethyl, propyl, butyl, vinyl, allyl, propenylmethyl or ethoxyethyl each optionally substituted with up to two groups independently selected from (C₁-C₄)alkyl, (C₁-C₄)alkoxy, (C₁-C₄)alkoxycarbonyl, hydroxy(C₁-C₄)alkyl, cyano(C₁-C₄)alkyl, (C₁-C₄)haloalkyl, (C₁-C₄)haloalkoxy, (C₁-C₄)alkylamino, di(C₁-C₄)alkylamino, halogen, cyano, oxo, nitro, hydroxy, amino, MeSO₂—, MeSO₂N(Me)(C₁-C₄)alkyl, MeSO₂NH(C₁-C₄)alkyl, H₂NC(═O)CMe₂(C₁-C₄)alkyl, H₂NC(═O)CHMe(C₁-C₄)alkyl and H₂NC(═O)CH₂(C₁-C₄)alkyl.
 4. The compound of claim 1, wherein R¹ is methyl or ethyl.
 5. A pharmaceutical composition comprising: i) a pharmaceutically acceptable carrier or diluent; and ii) the compound of claim 1; or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof.
 6. A method of treating a subject with a disease or disorder selected from diabetes mellitus, obesity, symptoms of metabolic syndrome, glucose intolerance, hyperglycemia, hypertension, hyperlipidemia, insulin resistance, cardiovascular disease, dyslipidemia, atherosclerosis, lipodystrophy, osteoporosis, glaucoma, Cushing's syndrome, Addison's Disease, visceral fat obesity associated with glucocorticoid therapy, depression, anxiety, Alzheimer's disease, dementia, cognitive decline, polycystic ovarian syndrome, infertility, hypergonadism, tuberculosis, leprosy, psoriasis, wound healing, lipid disorders, hypertriglyceridemia, hypercholesterolemia, low HDL levels, high LDL levels, vascular restenosis, pancreatitis, abdominal obesity, neurodegenerative disease, retinopathy, nephropathy, neuropathy, coronary heart disease, stroke, peripheral vascular disease, hyperinsulinemia, viral diseases, and Syndrome X, comprising the step of administering to the subject an effective amount of the compound of claim
 1. 